CHAPTER 24 PCI VS. LYTICS IN ACUTE MI: THE GUSTO IIB TRIAL

A Clinical Trial Comparing Primary Coronary Angioplasty With Tissue Plasminogen Activator for Acute Myocardial Infarction. The Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators

N Engl J Med. 1997;336(23):1621–1628

BACKGROUND

Coronary angioplasty was first developed in Switzerland in the late 1970s and rapidly spread. Before the late 1990s, tissue plasminogen activator (tPA) was the standard of care for patients who presented with acute MI. Prior to this study, it was widely known that prompt reperfusion improved clinical outcomes but there was little data concerning the effectiveness of tPA in comparison to angioplasty.

OBJECTIVES

To compare the effectiveness of primary percutaneous coronary intervention (PCI) or angioplasty to thrombolytics with antithrombotics (heparin and hirudin).

METHODS

Randomized controlled trial conducted in 57 hospitals experienced in angioplasty in nine countries in 1994 and 1995.

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