The Relative Merits of Direct Angioplasty versus Intravenous Thrombolytic Therapy for the Treatment of Acute Myocardial Infarction

There is growing interest in the use of angioplasty as the primary method to achieve coronary artery reperfusion in patients with acute myocardial infarction. The use of thrombolytic therapy has been established as effective in many large clinical trials, while only a few small studies have been completed comparing primary angioplasty with thrombolytic therapy. This paper briefly compares the use of these two treatment modalities and concludes that primary angioplasty is the preferred approach in patients with cardiogenic shock and for those patients with large myocardial infarctions who have contraindications to thrombolytic therapy. Other patients with AMI should receive thrombolytic therapy unless there are contraindications to this treatment.