Fibrinolytic Strategy for ST-Segment-Elevation Myocardial Infarction: A Contemporary Review in Context of the COVID-19 Pandemic

Pedro Engel Gonzalez, Wally Omar, Kunal V. Patel, James A. De Lemos, Anthony A. Bavry, Thomas P. Koshy, Ajit S. Mullasari, Thomas Alexander, Subhash Banerjee, Dharam J. Kumbhani

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

The ongoing coronavirus disease 2019 pandemic has resulted in additional challenges for systems designed to perform expeditious primary percutaneous coronary intervention for patients presenting with ST-segment-elevation myocardial infarction. There are 2 important considerations: The guideline-recommended time goals were difficult to achieve for many patients in high-income countries even before the pandemic, and there is a steep increase in mortality when primary percutaneous coronary intervention cannot be delivered in a timely fashion. Although the use of fibrinolytic therapy has progressively decreased over the last several decades in high-income countries, in circumstances when delays in timely delivery of primary percutaneous coronary intervention are expected, a modern fibrinolytic-based pharmacoinvasive strategy may need to be considered. The purpose of this review is to systematically discuss the contemporary role of an evidence-based fibrinolytic reperfusion strategy as part of a pharmacoinvasive approach, in the context of the emerging coronavirus disease 2019 pandemic.

Original languageEnglish (US)
Article numbere009622
JournalCirculation: Cardiovascular Interventions
DOIs
StatePublished - Sep 1 2020

Keywords

  • Coronavirus
  • Fibrinolysis
  • Myocardial infarction
  • Pandemic
  • Reperfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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