Primary coronary angioplasty in acute myocardial infarction yields superior results in terms of effective vessel patency, recurrent ischemia and acute morbidity, as compared to intravenous thrombolysis. Despite obvious logistic and economic limitations, this early invasive approach could be strictly indicated in selected groups of patients.A prospective study to test the immediate and short-term results of an early invasive strategy with angioplasty in patients with high-risk acute myocardial infarction.Forty-one consecutive patients with high-risk acute myocardial infarction were submitted to coronary angiography and angioplasty of the involved vessel within 12 hours of onset of symptoms. Twenty-eight had anterior myocardial infarction and 6 were in cardiogenic shock.Primary success was achieved in 38 patients (93\%): 30 of these were discharged without complications or further revascularization procedures, and none has symptoms or re-infarction at one-month follow-up.Immediate invasive treatment with angioplasty in high-risk acute myocardial infarction seems to achieve good results, due to both effective infarct vessel recanalization, and early identification of candidates to urgent complete surgical revascularization.
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