ORIGINAL ARTICLE Rescue percutaneous coronary intervention for failed thrombolysis: results from a district general hospital

Objective: To assess the outcome of a policy of emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and electrocadiographic (ECG) evidence of failed reper-fusion after thrombolysis. Design: Observational study. Setting: District general hospital. Patients: A total of 109 consecutive patients with acute myocardial infarction who underwent emergency angiography and angioplasty for failed reperfusion diagnosed on the basis of standard ECG criteria. Main outcome measures: In-hospital mortality; death, infarct territory reinfarction, and reintervention by PCI or coronary artery bypass graft (CABG) during follow up; in-lab resource utilisation. Results: At initial angiography, 76 patients had Thrombolysis in Myocardial Infarction (TIMI) trial 0/1 flow and 33 had TIMI 2/3 flow. Fourteen patients were in cardiogenic shock. TIMI 3 flow was estab-lished or maintained in 93 patients (85%). Overall in-hospital mortality was 9%. It was 3 % in non-shock patients, 50 % in shocked patients, and 40 % when the procedure was unsuccessful (TIMI 0/1 flow post-procedure). Over a mean follow up of 30 months (>12 months of follow up in all patients) ther