The results of STREAM were presented at ACC meeting and study was published online in NEJM – “Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction”. In nutshell the results can be summarized as pre-hospital fibrinolysis with bolus tenecteplase in conjunction with timely coronary angiography was similar to primary PCI in patients with early STEMI who could not undergo primary PCI within 1 hour after the first medical contact. Patients who failed fibrinolysis underwent emergent PCI (36.3% of the fibrinolysis group). Cardiogenic shock and congestive heart failure occurred more often in the primary PCI group and intracranial hemorrhage and ischemic strokes were more frequent in the fibrinolysis group. The study findings are likely to be reassuring for some parts of the world while may change treatment strategies at other places.
