Rescue thrombolysis may work even though primary thrombolysis has failed

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7151.147 (Published 11 July 1998) Cite this as: BMJ 1998;317:147
  1. Joost P H Drenth (JPHDrenth@Compuserve.com), Resident in medicine,
  2. Astrid Uppelschoten, Research associate,
  3. Ton E H Hooghoudt, Consultant cardiologist,
  4. Evert J P Lamfers, Consultant cardiologist
  1. Canisius Wilhelmina Hospital, Department of Cardiology, 6532 SZ Nijmegen, Netherlands

    EDITOR—Gershlick and More discuss the new therapeutic options for myocardial infarction and suggest that patients in whom thrombolysis fails should receive rescue angioplasty.1 We challenge this view and propose that rescue thrombolysis might be considered in cases in which primary thrombolysis has failed.

    Two trials have compared rescue angioplasty with conservative management, with equivocal results. 2 3 One trial randomised patients with an occluded artery three hours after the onset of symptoms; it detected a non-significant reduction in mortality in the angioplasty group …

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