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The appropriate treatment for patients in whom reperfusion fails to occur after thrombolytic therapy for acute myocardial infarction remains unclear. There are few data comparing emergency percutaneous coronary intervention (rescue PCI) with conservative care in such patients, and none comparing rescue PCI with repeated thrombolysis. methods We conducted a multicenter trial in the United Kingdom involving 427 patients with ST-segment elevation myocardial infarction in whom reperfusion failed to occur (less than 50 percent ST-segment resolution) within 90 minutes after thrombolytic treatment | Rescue Angioplasty after Failed Thrombolytic Therapy for Acute Myocardial Infarction Rescue Angioplasty after Failed Thrombolytic Therapy for Acute Myocardial Infarction Anthony H. Gershlick M.B. B.S. Amanda Stephens-Lloyd R.N. M.Sc. Sarah Hughes R.N. B.A. Keith R. Abrams Ph.D. Suzanne E. Stevens M.Sc. Neal G. Uren M.D. Adam de Belder M.D. John Davis M.B. B.S. Michael Pitt M.B. B.S. Adrian Banning M.D. Andreas Baumbach M.D. Man Fai Shiu M.D. Peter Schofield M.D. Keith D. Dawkins M.D. Robert A. Henderson M.D. Keith G. Oldroyd M.D. and Robert Wilcox M.D. for the REACT Trial Investigators ABSTRACT From the Department of Cardiology University Hospitals of Leicester Leicester A.H.G. A.S.-L. S.H. the Departments of Health Sciences K.R.A. and Cardiovascular Sciences S.E.S. University of Leicester Leicester the Department of Cardiology Royal Infirmary Edinburgh Edinburgh N.G.U. Sussex Cardiac Centre Royal Sussex County Hospital Brighton A. de Belder the Department of Cardiology North Staffordshire Hospital Stoke-on-Trent J.D. the Department of Cardiology Heartlands Hospital Birmingham M.P. the Department of Cardiology John Radcliffe Hospital Oxford A. Banning the Department of Cardiology Bristol Royal Infirmary Bristol A. Baumbach the Department of Cardiology Walsgrave Hospital Coventry M.F.S. the Department of Cardiology Papworth Hospital Cambridge P.S. Wessex Cardiac Unit Southampton General Hospital Southampton K.D.D. Trent Cardiac Centre Nottingham City Hospital Nottingham R.A.H. the Department of Cardiology Western Infirmary Glasgow K.G.O. and the Department of Cardiovascular Medicine Queens Medical Centre Nottingham R.W. all in the United Kingdom. Address reprint requests to Dr. Gershlick at the University Hospitals of Leicester Groby St. Leicester LE3 9QP United Kingdom or at agershlick@aol.com. The participants in the Rescue Angioplasty versus Conservative Treatment or Repeat Thrombolysis REACT trial are listed in the Appendix. N Engl J Med 2005 353 2758-68. .
