11. Primary PCI compared with thrombolysis significantly reduced stroke. Overall, the recommendation is for primary PCI over thrombolysis in the first 3 hours of chest pain, in order to prevent stroke, and in patients presenting 3-12 hours after the onset of chest pain, to salvage myocardium as well as preventing stroke.
12. At present, there is no evidence to recommend facilitated PCI.
13. After successful thrombolysis, to improve patient outcome, the use of routine coronary angiography within 24 hours and PCI (if applicable) is recommended This applies even if the patient is asymptomatic patient and without demonstrable ischaemia.
14. If a PCI centre is not available within 24 hours, patients who have received successful thromblysis, with evidence of spontaneous or inducible ischaemia before discharge, should be referred to coronary angiography and revascularised accordingly independent of 'maximal' medical therapy.
Optimal time for PCI Guidelines
"The field of PCI is constantly and rapidly evolving," explains Professor Silber, "We are always waiting for the next study and development. Following each new study, we need to re-evaluate our thinking and clinical practice".
With the wealth of recent landmark studies and developments in the field of PCI, the ESC feels that it is the appropriate moment to review the data released to date and offer guidance on the recommended procedures.
"We [the Task Force on PCI of the ESC] believe it is time to set the European Guidelines on PCI. We want to acknowledge and present the incredible amount of recent developments, studies and data on PCI. Following this recent peak in activity, it is the optimal moment to issue these Guidelines and we expect that our recommendations should remain valid for at least two
Contact: Camilla Dormer
European Society of Cardiology