Thrombolysis in non-ST-elevation myocardial infarction: systematic review and meta-analysis of randomised controlled trials.

ABSTRACT:

Background

Guidelines strongly recommend reperfusion therapy, including thrombolysis and percutaneous coronary intervention, for ST-elevation myocardial infarction but contraindicate its use in most non-ST-elevation acute coronary syndromes (ACS). This practice largely stems from the landmark fibrinolytic therapy trialists (FTT) meta-analysis, which reported no benefit in patients without ST elevation (STE). However, the FTT included a subgroup from the ISIS-3 trial with substantial methodological issues, potentially obscuring a genuine treatment effect.

Methods

We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing thrombolysis vs placebo or no thrombolysis in ACS. Patients were grouped by ECG findings: STE, ST depression (STD) o

SUBMITTER: de Alencar JN 

PROVIDER: S-EPMC12606484 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature