Document Detail


Acute ST-elevation myocardial infarction.
MedLine Citation:
PMID:  22889871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Acute ST-elevation myocardial infarction (STEMI) is a major cause of morbidity, mortality, and disability. This review summarizes recent advances in the treatment of patients with STEMI.
RECENT FINDINGS: The best prehospital and interhospital transfer strategy for patients with STEMI is rapid transport to a percutaneous coronary intervention (PCI) center by Emergency Medical Services, with prehospital diagnosis and activation of the cardiac catheterization laboratory. Coronary angiography is now recommended for all patients with STEMI. Advances in adjunctive pharmacological and device therapy have improved primary PCI results. Thrombus aspiration, drug-eluting stents, systemic hypothermia for survivors of cardiac arrest with anoxic encephalopathy, and stem cells as reparative therapy have undergone recent evaluation.
SUMMARY: Primary PCI with stent implantation as soon as possible is the best treatment strategy for patients with STEMI. Aspirin, bivalirudin, and either prasugrel or ticagrelor are the best antithrombotic agents to support primary PCI. Thrombus aspiration and intra-aortic balloon counterpulsation are important device adjuncts. Systemic hypothermia appears to be an important advance for survivors of cardiac arrest with anoxic encephalopathy, but the benefits of stem cell therapy have yet to be proven.
Authors:
Eric R Bates; Daniel S Menees
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  18     ISSN:  1531-7072     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2013-01-30     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-23     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. ebates@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use
Coronary Angiography
Drug-Eluting Stents
Hemodynamics
Humans
Hypothermia, Induced
Immunoglobulin Fab Fragments / therapeutic use
Myocardial Infarction / diagnosis*,  drug therapy,  therapy
Myocardial Reperfusion
Platelet Aggregation Inhibitors / administration & dosage,  therapeutic use*
Ticlopidine / analogs & derivatives,  therapeutic use
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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