| Lowering mortality in ST-elevation myocardial infarction and non-ST-elevation myocardial infarction: key prehospital and emergency room treatment strategies. | |
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MedLine Citation:
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PMID: 19318957 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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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:
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Created Date: 2009-09-04 Completed Date: 2009-11-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 244-55 Citation Subset: IM |
Affiliation:
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SAMU du Nord Emergency Department, Lille University Hospital France, Lille, France. pgoldstein@chru-lille.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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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:
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0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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