Despite presenting early after symptom onset, some patients with ST-segment elevation myocardial infarction are unable to receive mechanical reperfusion within 60 min. The STREAM trial shows that, among these individuals, fibrinolysis with early angiography is associated with outcomes comparable to modestly delayed primary percutaneous coronary intervention, but with an increased risk of intracranial haemorrhage.
- Akshay Bagai
- Christopher B. Granger