Thrombolytic therapy vs PCI

Thrombolytic therapy vs PCI

Timely performed PCI in an experienced high volume centre is better than thrombolysis. If it cannot be performed, thrombolysis has to be considered. Long delays to PCI are associated with a worse outcome. Delays can be from onset of symptoms to first medical contact, door to needle or door to balloon time. PCI related delay is door to balloon – door to needle time. If it is less than 60 minutes, primary PCI is useful. CAPTIM trial has shown lower mortality in STEMI patients receiving prehospital thrombolysis within 2 hours of onset of symptoms. There is role for rescue PCI as well as facilitated PCI.