What is the optimal time window to perform early percutaneous coronary intervention after fibrinolysis for acute myocardial infarction?
A: The time to percutaneous coronary intervention (PCI) was well under 24 hours after fibrinolysis in previous studies, and there was no difference among the trials in efficacy relative to the time to PCI. The intervals ranged from 2 to 17 hours. A two-hour interval after fibrinolysis should be considered to be the lowest acceptable interval, since PCI immediately after fibrinolysis has proven to be ineffective. An interval of 17 hours seems to be as good as PCI at 2 hours. Waiting longer than 24 hours can be disadvantageous, given the increasing risk of reocclusion of the infarct-related artery. Thus, the optimal window for early PCI after fibrinolysis is somewhere between 2 and 24 hours.