Baim D S, Braunwald E, Feit F, Knatterud G L, Passamani E R, Robertson T L, Rogers W J, Solomon R E, Williams D O
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
J Am Coll Cardiol. 1990 Apr;15(5):1188-92. doi: 10.1016/0735-1097(90)90263-o.
Given the many thrombolytic agents and the number of ways in which they can be combined with mechanical revascularization, the treatment of acute myocardial infarction has been the subject of active study and lively debate, which are likely to continue for some time. Several studies, including TIMI IIA (2,3,10,22), have suggested that immediate catheterization and angioplasty offer no clinical benefit and have a greater complication rate than a more delayed invasive strategy, but TIMI II (1) and SWIFT (16) trials have suggested that an even more conservative strategy of reserving catheterization and coronary angioplasty after thrombolytic therapy for patients with recurrent spontaneous or exercise-induced ischemia may be the most desirable approach for the majority of patients similar to those entered into these trials.
鉴于有多种溶栓药物以及它们与机械性血管再通相结合的方式，急性心肌梗死的治疗一直是积极研究和激烈辩论的主题，这种情况可能还会持续一段时间。包括TIMI IIA（2,3,10,22）在内的多项研究表明，立即进行导管插入术和血管成形术并无临床益处，且并发症发生率高于延迟性更强的侵入性策略，但TIMI II（1）和SWIFT（16）试验表明，对于大多数与参与这些试验的患者相似的患者而言，更保守的策略，即对溶栓治疗后出现复发性自发性或运动诱发缺血的患者保留导管插入术和冠状动脉血管成形术，可能是最理想的方法。
