JACC Vol. 16. MO. 3 September 1990:551-2

5.51

e procedures were pe

that a representative wave ~~farct~o~(anterior in 74% an ve a mean ejection fraction of about single plane right anterior oblique

cates that Nath et al. (1) selected a low risk group for muitivessel angioplasty. Although this group may be most appropriate for multivessel angioplasty soon after myocardial infarction, one would expect such patients to also have an excellent outcome and 9ow mortality with other treatment-surgical management or possibly medical therapy. Because the results of this study were obtained in low risk patients, it may noi be possible to obtain similar results in a higher risk group. Of the patients reported on by Nath et al. (9) 21% received thrombolytic therapy before angioplasty. This proportion of patients receiving tbrombo9yt~ctherapy for Q wave infarction is similar to the experience of others (5,6)

*Editorials published in Jounlal of rite Attleriratt College of Cdiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology. From the Department of Medicine. Division of Cardiology, University of Washington School of Medicine. Seattle, Washington. Address for rem&&: J. Ward Kennedy. MD. Division of Cardiology. University of Washington School of Medicine, Seattle, Washington 98195. 01990 by the American

College of Cardiology

There is considerable i onary artery angioplasty as a pri yocardial infarction. Although thts approa nd laboratoriesto

is of interest that Natb and colleagues (9) only performed primary angioplasty in one patient in whom they dilated the infarct vessel as the first of a two stage procedure. cationsfor a~g~o~~as~y in evolving that there is an important role be9 plasty in these patients with evolving Q wave infarction who have contraindications to thrombolytic therapy. Although the relative efficacyand safety of primary angioplastyversus intravenous thrombolytic therapy has not been carefully ized trial, it is likely that evaluated with a large ran omplished by direct angiocoronary artery reperfusion plasty will resultin improvedsurvivalin hi as has thrombolytic therapy (99).

Is there a role for multivessel coronary angioplasty early after acute myocardial infarction?

JACC Vol. 16. MO. 3 September 1990:551-2 5.51 e procedures were pe that a representative wave ~~farct~o~(anterior in 74% an ve a mean ejection frac...
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