Reperfusion strategies in acute ST-segment elevation myocardial infarction
- 1 November 2008
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Cardiology
- Vol. 23 (6), 613-619
- https://doi.org/10.1097/hco.0b013e3283131357
Abstract
Chronic heart disease is the leading cause of death in the United States, and coronary artery disease constitutes the number one cause among them. ST-segment elevation myocardial infarction comprises a large number of events per year in the United States. It is important to develop an integrated framework of reperfusion strategies to minimize ischemia among these patients. The objective of this review is to outline available reperfusion options, which can then form an evidence-based approach to implementing complementary pharmacologic and mechanical strategies that can enhance timely and effective coronary reperfusion. The updated American College of Cardiology/American Heart Association clinical practice guidelines espouse the important goal of facilitating rapid recognition and treatment of patients who present acutely with ST-segment elevation myocardial infarction so that door-to-needle (or the first medical contact-to-needle) time for initiation of fibrinolytic therapy can be achieved within 30 min or door-to-balloon (or the first medical contact-to-balloon) time for primary percutaneous coronary intervention can be achieved within 90 min. In conclusion, whatever reperfusion strategy is adopted, the ultimate objective should be to obtain prompt and effective reperfusion of ischemic myocardium as early as possible. The most efficacious and safe strategy for the treatment of ST-segment elevation myocardial infarction patients involves an integrated approach of highly organized networks to enhance the availability and use of primary percutaneous coronary intervention and to promote the selective use of fibrinolytic therapy, especially prehospital fibrinolysis, when primary percutaneous coronary intervention is not immediately available.Keywords
This publication has 40 references indexed in Scilit:
- Reperfusion Strategies in Acute ST-Segment Elevation Myocardial Infarction: A Comprehensive Review of Contemporary Management OptionsJournal of the American College of Cardiology, 2007
- Rescue Angioplasty or Repeat Fibrinolysis After Failed Fibrinolytic Therapy for ST-Segment Myocardial Infarction: A Meta-Analysis of Randomized TrialsJournal of the American College of Cardiology, 2007
- Coronary Intervention for Persistent Occlusion after Myocardial InfarctionNew England Journal of Medicine, 2006
- A Meta-Analysis of Randomized Trials of Rescue Percutaneous Coronary Intervention After Failed FibrinolysisThe American Journal of Cardiology, 2006
- Rescue Angioplasty after Failed Thrombolytic Therapy for Acute Myocardial InfarctionNew England Journal of Medicine, 2005
- Primary stenting of occluded native coronary arteries: Final results of the Primary Stenting of Occluded Native Coronary Arteries (PRISON) studyAmerican Heart Journal, 2004
- Facilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the facilitated intervention with enhanced reperfusion speed to stop events (FINESSE) trialAmerican Heart Journal, 2004
- Impact of Time to Treatment on Mortality After Prehospital Fibrinolysis or Primary AngioplastyCirculation, 2003
- Percutaneous coronary intervention versus fibrinolytic therapy in acute myocardial infarction: is timing (almost) everything?The American Journal of Cardiology, 2003
- Evaluation of the time saved byprehospital initiation of reteplase forST-elevation myocardial infarction: Results of the early retavase-thrombolysisin myocardial infarction (ER-TIMI) 19 trialJournal of the American College of Cardiology, 2002