Coronary Artery Disease (D Feldman, Section Editor)

Current Treatment Options in Cardiovascular Medicine

, 16:302

Therapy in ST-elevation myocardial infarction: reperfusion strategies, pharmacology and stent selection

  • Vikas SinghAffiliated withCardiovascular Division, and the Elaine and Sydney Sussman Cardiac Catheterization Laboratory, University of Miami Hospital, Miller School of Medicine
  • , Mauricio G. CohenAffiliated withCardiovascular Division, and the Elaine and Sydney Sussman Cardiac Catheterization Laboratory, University of Miami Hospital, Miller School of Medicine Email author 

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Opinion statement

The estimated annual incidence of new and recurrent myocardial infarction (MI) in the U.S. is 715,000 events. Primary percutaneous coronary intervention (PCI) is the reperfusion strategy of choice in most patients with acute ST-elevation myocardial infarction (STEMI). Recent advances in percutaneous techniques and devices, including manual aspiration catheters and newer generation drug eluting stents and pharmacologic therapies, such as novel antiplatelets and anticoagulants have led to significant improvements in the acute and long-term outcomes for these patients. Implementation of community-wide systems directed to shorten treatment times tied to closely monitored quality improvement processes have led to further advances in STEMI care. Recent data suggests that transradial access for primary PCI is associated with improved outcomes. This contemporary review discusses the strategies for reperfusion, pharmacological therapy and stent selection process involved in STEMI.

Keywords

Myocardial infarction Thrombolytic therapy Primary percutaneous coronary intervention Coronary stents