Rescue PCI after failed clot-busting drugs caused worse heart outcomes than planned angiography

When a clot-busting drug fails to open a blocked heart artery, doctors often rush patients to the catheterization lab for a rescue procedure. This study looked at 583 patients with heart attacks who needed this rescue intervention. They compared those who went to a community hospital first against those who went to an ambulance that took them directly to a capable facility. The results were stark. Patients who received the rescue procedure had significantly worse outcomes than those who received their scheduled angiography. Their hearts showed less improvement on scans, and more suffered death, shock, heart failure, or a second heart attack within 30 days. The risk of bleeding into the brain was also higher for the rescue group. This finding suggests that rushing to a catheterization lab after a failed drug treatment might not be the best path. Instead, getting to a facility that can perform the procedure quickly and safely seems to offer better protection. The study highlights the value of systems that move patients efficiently to the right care without unnecessary delays.