Document Detail


Reperfusion therapy in ST-elevation myocardial infarction: guidelines, strategies, pharmacology, and stent selection.
MedLine Citation:
PMID:  23229365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of acute ST-elevation myocardial infarction (STEMI) has rapidly evolved with many advances made in the past decade. Percutaneous coronary intervention is the preferred strategy when available, although there remains a role for thrombolytic therapy, with prompt reperfusion as the primary goal. With regards to antithrombotic therapy, bivalirudin now has a significant role in STEMI care with improved outcomes over unfractionated heparin plus GP IIb/IIIa inhibitors. Dual antiplatelet therapy has become a mainstay of treatment with combination of aspirin and clopidogrel, as well as an expanding role of more potent novel agents, prasugrel and ticagrelor. In primary PCI in STEMI, coronary stents are now being used routinely, although short-term and long-term outcomes of drug-eluting stents (DES) versus bare metal stents (BMS) continue to be studied. Recent meta-analyses have examined the trade-off of lower rates of in-stent restenosis and need for target vessel revascularization with DES versus the potential increase in the risk of stent thrombosis and need for longer course of dual antiplatelet therapy. This review will discuss the current STEMI guidelines and strategies, recent advances in pharmacotherapy, and data on stent selection.
Authors:
B D Ghosh; R V Swaminathan; L K Kim; D N Feldman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva medica     Volume:  103     ISSN:  0026-4806     ISO Abbreviation:  Minerva Med.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-04-16     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0400732     Medline TA:  Minerva Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  431-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, New York Presbyterian Hospital, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary
Drug-Eluting Stents
Humans
Myocardial Infarction / therapy*
Myocardial Reperfusion / methods
Platelet Aggregation Inhibitors / therapeutic use
Practice Guidelines as Topic
Stents
Thrombolytic Therapy / methods
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors

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


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