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myocardial revascularization in acute myocardial infarction for failed fibrinolysis (rescue revascularisation), clinical trials results

repeat fibrinolysis versus no repeat fibrinolysis
REACT (repeat fibrinolysis), 2005
repeated thrombolysis
versus
conservative treatment with unfractionated heparin for 24h
patients with ST-segment elevation myocardial infarction and failed reperfusion (less than 50 percent ST-segment resolution) within 90 minutes after thrombolytic treatment open
Follow-up duration: 6 months
Sarullo, 2000
thrombolytic treatment (rTPA 50 mg), 10 mg as bolus plus 40 mg in 60 minutes
versus
placebo
patients with large AMI and failed thrombolysisdouble blind
Follow-up duration: in hospital
Mounsey, 1995
alteplase (tissue type plasminogen activator (rt-PA) 100 mg over three hours)
versus
placebo
patients with acute myocardial infarction and electrocardiographic evidence of failed reperfusion
Follow-up duration: 6 weeks
rescue PTCA versus no rescue PTCA
Belenkie, 1992
rescue PTCA
versus
conservative treatment
patients with a persistently occluded infarct artery following thrombolytic therapy more than 3 h after symptom onset open
Follow-up duration: hospital stay
Canda
REACT (rescue PCI), 2005
rescue PCI
versus
conservative treatment (with unfractionated heparin for 24 hours)
patients with ST-segment elevation myocardial infarction and failed reperfusion (less than 50 percent ST-segment resolution) within 90 minutes after thrombolytic treatmentopen
Follow-up duration: 6-month
MERLIN, 2004
emergency coronary angiography with or without rescue PCI
versus
conservative treatment
patients with STEMI and failed fibrinolysis
Follow-up duration: 30-day
RESCUE II, 2000
PCI
versus
conservative
patient with TIMI II flow after fibrinolytic therapy for moderate to large MI
Follow-up duration: 30-day
RESCUE, 1994
balloon angioplasty supplemented by further thrombolytic therapy as needed
versus
conservative therapy (aspirin, heparin, and coronary vasodilators)
patients with first anterior wall infarction and angiographically demonstrated occluded infarct vessel within 8 hours of chest pain onset after thrombolysis
Follow-up duration: 30-day

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