The goals of the initial management of ST-segment elevationmyocardial infarction include swift restoration of flow withinthe occluded coronary artery, prevention of early reinfarction,and avoidance of complications of reperfusion therapy.1,2 Theselection of the reperfusion strategy, either the preferredpercutaneous coronary intervention (PCI) or fibrinolysis, isusually driven by institutional access to primary PCI. Thus,the decision that clinicians most commonly grapple with at thetime of the patient's presentation is the selection of adjunctiveanticoagulant and antiplatelet therapy. In this issue of theJournal, Stone and colleagues report on a large, randomizedtrial that tested an anticoagulant . . . [Full Text of this Article]
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From the Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston.
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