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Figure 4 Hypothetical proportions of patients with TIMI flow grade 3 over time for standard (full-dose) thrombolysis (17,23–25), primary or direct PTCA (23,24), combined therapy with abciximab and reduced-dose thrombolysis (6,9), and facilitated PCI (as defined in this study). Compared with standard thrombolysis, which achieves TIMI grade 3 flow rates of 50% at 60 min and 60% at 90 min, primary angioplasty takes longer to perform, reducing the early benefit, but achieves greater TIMI grade 3 flow rates by 90 min. Combination pharmacological therapy can achieve higher early and late TIMI grade 3 flow as shown in the SPEED trial. The addition of facilitated PCI to combination therapy improves the later TIMI grade 3 flow rate without sacrificing the early benefit of the pharmacological approach.
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