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Table 2 Most appropriate reperfusion strategy by time from symptom onset and anticipated treatment delays

From: Achieving the earliest possible reperfusion in patients with acute coronary syndrome: a current overview

Treatment delay

Time from symptom onset

< 2 h

2–3 h

3–6 h*

< 60 min

Primary PCI

Primary PCI or fibrinolysis†

Primary PCI

60–120 min

Fibrinolysis†

Primary PCI or fibrinolysis†

Primary PCI

> 120 min

Fibrinolysis†

Fibrinolysis†

Fibrinolysis†

  1. Patients with higher risk, including those with Killip class > 1, may benefit from primary PCI even when there are treatment delays up to 120 min
  2. PCI percutaneous coronary intervention
  3. *If time from symptom onset is greater than 6 h, primary PCI is appropriate regardless of treatment delay
  4. †In case of fibrinolytic therapy, immediate transfer to a PCI center after fibrinolysis should be considered for cardiac angiography within 3 to 24 h
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Journal of Intensive Care

ISSN: 2052-0492