Document Detail


Lowering mortality in ST-elevation myocardial infarction and non-ST-elevation myocardial infarction: key prehospital and emergency room treatment strategies.
MedLine Citation:
PMID:  19318957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Achieving optimal outcomes in patients with acute coronary syndromes depends on early reperfusion supported by rapid initiation of adjunctive antiplatelet and anticoagulant therapy. The use of the ambulance setting to initiate treatment provides an opportunity to dramatically reduce the time between symptom onset and reperfusion, and a growing body of evidence shows that prehospital reperfusion therapy is associated with significantly better short-term and long-term outcomes than in-hospital administration of the same treatment. In patients with ST-segment elevation myocardial infarction, fibrinolysis must be supported by optimal antiplatelet therapy. Recent studies have shown that, compared with aspirin monotherapy, treatment with a combination of aspirin and clopidogrel significantly improves outcome. The majority of these patients should also receive heparin (unfractionated or low molecular weight). The experience of several European emergency response systems initiating prehospital treatment, shows that this strategy is highly effective in improving outcomes for patients with acute coronary syndromes.
Authors:
Patrick Goldstein; Frederic Lapostolle; Gabriel Steg; Nicolas Danchin; Nathalie Assez; Gilles Montalescot; Sandrine Charpentier; Eric Wiel; Jean Michel Juliard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  16     ISSN:  1473-5695     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  244-55     Citation Subset:  IM    
Affiliation:
SAMU du Nord Emergency Department, Lille University Hospital France, Lille, France. pgoldstein@chru-lille.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / drug therapy
Catheter Ablation
Drug Therapy, Combination
Electrocardiography
Emergency Medical Services*
Emergency Service, Hospital
Fibrinolytic Agents / therapeutic use*
Humans
Myocardial Infarction / drug therapy*
Myocardial Reperfusion
Platelet Aggregation Inhibitors / therapeutic use*
Practice Guidelines as Topic
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors

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


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