الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Primary percutaneous coronary intervention (PPCI) is an effective treatment for STEMI when it can be performed rapidly. Many patients with STEMI present to hospitals that do not have on site PCI capabilities, thus they cannot undergo PCI within the timelines recommended in the guidelines; instead, they receive lytics as the initial reperfusion therapy followed by early routine post-thrombolysis angiography with subsequent PCI within 3–24 h after successful lytic therapy (pharmacoinvasive strategy).The aim of the present study is to assess safety and efficacy of pharmacoinvasive strategy using streptokinase compared to primary PCI on degree of myocardial salvage and outcomes.This registry included 94 STEMI patients, 51 underwent PPCI and 43 patients were allocated to full dose lytic therapy followed by early routine coronary intervention (pharmacoinvasive strategy) in the period from 2017 to 2019 with follow up in hospital and one month after the procedure comparing the efficacy and safety of PPCI versus pharmacoinvasive strategy with a full dose streptokinase.All our patients underwent full history taking, clinical examination, biochemical assessment, ECG and echocardiography. All our patients underwent PCI ± stenting. We followed up the patients for one month after PCI for MACE including, recurrent infarction death, Stroke, and Heart failure.Our study showed that a PhI strategy with full-dose streptokinase and timely PCI was noninferior (and even superior) to PPCI in terms of incidence of complete epicardial and myocardial reperfusion. Also, The trial showed no significant between-group difference in the all-cause death, shock, congestive heart failure, or reinfarction at 30-day follow up. Whereas delayed time for intervention, higher serum creatinine, lower EF at admission, increased number of affected vessels and decreased Post-PCI TIMI grade were all associated with MACE in both groups.Conclusion:Particularly convenient to developing countries with limited health budgets and not well-organized STEMI logistics for PPCI, the results of our study suggest PhI strategy as an effective non inferior alternative for patients with STEMI who cannot receive timely PPCI.