Skip to main content
SpringerLink
Log in

STEMI-Guidelines 2008 – Konsequenzen für die heutige Infarktversorgung im ländlichen Raum?

STEMI guidelines 2008 – Do they influence today's myocardial infarction treatment strategies in rural areas?

  • Clinical seminar
  • Published:
Wiener Medizinische Wochenschrift Aims and scope Submit manuscript

Summary

2008 new guidelines for the management of patients with ST-elevation myocardial infarction were published by the European Society of Cardiology. For daily clinical practice, changes in recommendations concerning the preferred revascularization therapy according to different time delays are of great interest. This review focuses on possible implications of these new guidelines on the choice of reperfusion strategies in rural areas.

Zusammenfassung

2008 wurden von der Europäischen Kardiologischen Gesellschaft neue Richtlinien zur Versorgung von Patienten mit ST-Hebungs-Myokardinfarkten veröffentlicht. Im klinischen Alltag sind vor allem Änderungen im Hinblick auf die zu bevorzugende Revaskularisations-Strategie in Abhängigkeit von verschiedenen Zeitintervallen von Interesse. Diese Übersichtsarbeit befasst sich mit den möglichen Auswirkungen dieser neuen Richtlinien auf die Wahl der Revaskularisations-Strategie im ländlichen Raum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Van de Werf F, Bax J, Betriu A, et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J, 29: 2909–2945, 2008

    Article  CAS  PubMed  Google Scholar 

  • Stone GW, Witzenbichler B, Guagliumi G, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med, 358: 2218–2230, 2008

    Article  CAS  PubMed  Google Scholar 

  • Yusuf S, Mehta SR, Chrolavicius S, et al. Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. JAMA, 295: 1519–1530, 2006

    Article  CAS  PubMed  Google Scholar 

  • Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. Eur Heart J, 28: 2525–2538, 2007

    Article  PubMed  Google Scholar 

  • Van de Werf F, Ardissino D, Betriu A, et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J, 24: 28–66, 2003

    Article  PubMed  Google Scholar 

  • De Luca G, Suryapranata H, Stone GW, et al. Abciximab as adjunctive therapy to reperfusion in acute ST-segment elevation myocardial infarction: a meta-analysis of randomized trials. JAMA, 293: 1759–1765, 2005

    Article  CAS  PubMed  Google Scholar 

  • Beinart SC, Kolm P, Veledar E, et al. Long-term cost effectiveness of early and sustained dual oral antiplatelet therapy with clopidogrel given for up to one year after percutaneous coronary intervention results: from the Clopidogrel for the Reduction of Events During Observation (CREDO) trial. J Am Coll Cardiol, 46: 761–769, 2005

    Article  CAS  PubMed  Google Scholar 

  • Fox KA, Mehta SR, Peters R, et al. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) Trial. Circulation, 110: 1202–1208, 2004

    Article  CAS  PubMed  Google Scholar 

  • Sabatine MS, Cannon CP, Gibson CM, et al. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med, 352: 1179–1189, 2005

    Article  CAS  PubMed  Google Scholar 

  • von Beckerath N, Taubert D, Pogatsa-Murray G, Schomig E, Kastrati A, Schomig A. Absorption, metabolization, and antiplatelet effects of 300-, 600-, and 900-mg loading doses of clopidogrel: results of the ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen: Choose Between 3 High Oral Doses for Immediate Clopidogrel Effect) Trial. Circulation, 112: 2946–2950, 2005

    CAS  PubMed  Google Scholar 

  • Zeymer U, Arntz HR, Darius H, Huber K, Senges J. Efficacy and safety of clopidogrel 600 mg administered pre-hospitally to improve primary percutaneous coronary intervention in patients with acute myocardial infarction (CIPAMI): study rationale and design. Cardiology, 108: 265–272, 2007

    Article  CAS  PubMed  Google Scholar 

  • De Luca G, Suryapranata H, Zijlstra F, et al. Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty. J Am Coll Cardiol, 42: 991–997, 2003

    Article  PubMed  Google Scholar 

  • Nallamothu B, Fox KA, Kennelly BM, et al. Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Heart, 93: 1552–1555, 2007

    Article  CAS  PubMed  Google Scholar 

  • Nallamothu BK, Bates ER. Percutaneous coronary intervention versus fibrinolytic therapy in acute myocardial infarction: is timing (almost) everything? Am J Cardiol, 92: 824–826, 2003

    Article  PubMed  Google Scholar 

  • Betriu A, Masotti M. Comparison of mortality rates in acute myocardial infarction treated by percutaneous coronary intervention versus fibrinolysis. Am J Cardiol, 95: 100–101, 2005

    Article  PubMed  Google Scholar 

  • Nallamothu BK, Antman EM, Bates ER. Primary percutaneous coronary intervention versus fibrinolytic therapy in acute myocardial infarction: does the choice of fibrinolytic agent impact on the importance of time-to-treatment? Am J Cardiol, 94: 772–774, 2004

    Article  PubMed  Google Scholar 

  • Boersma E. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J, 27: 779–788, 2006

    Article  PubMed  Google Scholar 

  • Pinto DS, Kirtane AJ, Nallamothu BK, et al. Hospital delays in reperfusion for ST-elevation myocardial infarction: implications when selecting a reperfusion strategy. Circulation, 114: 2019–2025, 2006

    Article  PubMed  Google Scholar 

  • Danchin N, Coste P, Ferrieres J, et al. Comparison of thrombolysis followed by broad use of percutaneous coronary intervention with primary percutaneous coronary intervention for ST-segment-elevation acute myocardial infarction: data from the french registry on acute ST-elevation myocardial infarction (FAST-MI). Circulation, 118: 268–276, 2008

    Article  PubMed  Google Scholar 

  • Danchin N, Blanchard D, Steg PG, et al. Impact of prehospital thrombolysis for acute myocardial infarction on 1-year outcome: results from the French Nationwide USIC 2000 Registry. Circulation, 110: 1909–1915, 2004

    Article  PubMed  Google Scholar 

  • Eisenberg PR, Sobel BE, Jaffe AS. Activation of prothrombin accompanying thrombolysis with recombinant tissue-type plasminogen activator. J Am Coll Cardiol, 19: 1065–1069, 1992

    Article  CAS  PubMed  Google Scholar 

  • Gram J, Munkvad S, Leebeek FW, Kluft C, Jespersen J. Reactive coagulation induced by plasmin in patients treated with recombinant tissue-type plasminogen activator. Coron Artery Dis, 4: 371–377, 1993

    Article  CAS  PubMed  Google Scholar 

  • Fernandez-Aviles F, Alonso JJ, Pena G, et al. Primary angioplasty vs. early routine post-fibrinolysis angioplasty for acute myocardial infarction with ST-segment elevation: the GRACIA-2 non-inferiority, randomized, controlled trial. Eur Heart J, 28: 949–960, 2007

    Article  PubMed  Google Scholar 

  • Le May MR, Wells GA, Labinaz M, et al. Combined angioplasty and pharmacological intervention versus thrombolysis alone in acute myocardial infarction (CAPITAL AMI study). J Am Coll Cardiol, 46: 417–424, 2005

    Article  PubMed  Google Scholar 

  • Fernandez-Aviles F, Alonso JJ, Castro-Beiras A, et al. Routine invasive strategy within 24 hours of thrombolysis versus ischaemia-guided conservative approach for acute myocardial infarction with ST-segment elevation (GRACIA-1): a randomised controlled trial. Lancet, 364: 1045–1053, 2004

    Article  PubMed  Google Scholar 

  • Cantor WJ, Fitchett D, Borgundvaag B, et al. Routine early angioplasty after fibrinolysis for acute myocardial infarction. N Engl J Med, 360: 2705–2718, 2009

    Article  PubMed  Google Scholar 

  • Suessenbacher A, Doerler J, Alber H, et al. Gender-related outcome following percutaneous coronary intervention for ST-elevation myocardial infarction: data from the Austrian acute PCI registry. EuroIntervention, 4: 271–276, 2008

    PubMed  Google Scholar 

  • Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): randomised trial. Lancet, 367: 569–578, 2006

  • Van't Hof AW, Ten Berg J, Heestermans T, et al. Prehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME 2): a multicentre, double-blind, randomised controlled trial. Lancet, 372: 537–546, 2008

    Article  PubMed  CAS  Google Scholar 

  • Ellis SG, Tendera M, de Belder MA, et al. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med, 358: 2205–2217, 2008

    Article  CAS  PubMed  Google Scholar 

  • Keeley EC, Boura JA, Grines CL. Comparison of primary and facilitated percutaneous coronary interventions for ST-elevation myocardial infarction: quantitative review of randomised trials. Lancet, 367: 579–588, 2006

    Article  CAS  PubMed  Google Scholar 

  • Di Mario C, Dudek D, Piscione F, et al. Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet, 371: 559–568, 2008

    Article  CAS  PubMed  Google Scholar 

  • White HD, Chew DP. Acute myocardial infarction. Lancet, 372: 570–584, 2008

    Article  CAS  PubMed  Google Scholar 

  • Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet, 343: 311–322, 1994

    Google Scholar 

  • ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet, 2: 349–360, 1988

    Google Scholar 

  • Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet, 1: 397–402, 1986

    Google Scholar 

  • ISIS-3 (Third International Study of Infarct Survival) Collaborative Group. ISIS-3: a randomised comparison of streptokinase vs tissue plasminogen activator vs anistreplase and of aspirin plus heparin vs aspirin alone among 41,299 cases of suspected acute myocardial infarction. Lancet, 339: 753–770, 1992

    Article  Google Scholar 

  • The International Study Group. In-hospital mortality and clinical course of 20,891 patients with suspected acute myocardial infarction randomised between alteplase and streptokinase with or without heparin. Lancet, 336: 71–75, 1990

    Article  Google Scholar 

  • The GUSTO investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med, 329: 673–682, 1993

    Article  Google Scholar 

  • Neuhaus KL, Feuerer W, Jeep-Tebbe S, Niederer W, Vogt A, Tebbe U. Improved thrombolysis with a modified dose regimen of recombinant tissue-type plasminogen activator. J Am Coll Cardiol, 14: 1566–1569, 1989

    Article  CAS  PubMed  Google Scholar 

  • Randomised, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT): trial to investigate equivalence. International Joint Efficacy Comparison of Thrombolytics. Lancet, 346: 329–336, 1995

  • The Continuous Infusion versus Double-Bolus Administration of Alteplase (COBALT) Investigators. A comparison of continuous infusion of alteplase with double-bolus administration for acute myocardial infarction. N Engl J Med, 337: 1124–1130, 1997

    Article  Google Scholar 

  • Van De Werf F, Adgey J, Ardissino D, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet, 354: 716–722, 1999

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universitätsklinik für Innere Medizin III, Kardiologie, Medizinische Universität Innsbruck, Innsbruck, Austria

    Alois Suessenbacher, Maria M. Wanitschek, Jakob Doerler, Otmar Pachinger & Hannes F. Alber

Authors
  1. Alois Suessenbacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria M. Wanitschek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jakob Doerler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Otmar Pachinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hannes F. Alber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hannes F. Alber.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suessenbacher, A., Wanitschek, M., Doerler, J. et al. STEMI-Guidelines 2008 – Konsequenzen für die heutige Infarktversorgung im ländlichen Raum?. Wien Med Wochenschr 160, 54–60 (2010). https://doi.org/10.1007/s10354-009-0739-8

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10354-009-0739-8

Keywords

Schlüsselwörter

Search

Navigation