Percutaneous сoronary Interventions in patients with ST-segment elevation myocardial Infarction and totally occluded culprit atery after pre-hospital thrombolysis

Introduction Despite the reduction in time to reperfusion with pre-hospital thrombolysis (PT), about 40% of patients do not achieve culprit artery patency.(1) In such cases, rescue
percutaneous coronary interventions (PCI) reduce the risks of recurrent MI and death compared to conservative therapy.(2,3) Some studies show no differences between rescue and primary
PCI in reducing the composite of death, shock, congestive heart failure, or reinfarction.(4,5) However, the results of PCI in patients with a completely occluded culprit artery after
PT are still insufficiently explored. We hypothesized that persistent infarct-related artery occlusion after PT can worsen the prognosis.

 The aim of this study was to evaluate inhospital outcomes of PCI in patients with acute STEMI with
completely occluded culprit artery after PT. Study population Altogether 1,103 consecutive patients with STEMI admitted to the coronary care unit and submitted to PCI at our center from January 2005 to January 2015 were included in the analysis. Some patients underwent ambulance-based, fulldose tenecteplase thrombolysis, and since 2008, PT has been
performed.