Angioplasty or thrombolysis for acute infarction?

The benefit of thrombolytic therapy for acute myocardial infarction has been conclusively established by many trials. Direct angioplasty (without thrombolytic therapy) is often utilized urgently for patients with acute infarction based on observational studies. Recently, three randomized trials compared outcomes of patients undergoing thrombolysis versus direct angioplasty. The results of these trials indicate that either strategy, if applied early, can benefit patients with acute infarction. Specific advantages of angioplasty include slightly higher patency and flow rates in the infarct-related artery. However, thrombolysis is more readily available to large segments of the population. Either therapy must be applied early to be effective.