Pre PCI hospital antithrombotic therapy for ST elevation myocardial infarction: striving for consensus.
Journal of Thrombosis and Thrombolysis · 2012-05-08 · Other / unclear
Abstract
Strong evidence exists in favor of rapid transfer of a patient suffering an ST-elevation myocardial infarction (STEMI) to the nearest hospital with primary percutaneous coronary intervention (PCI) capability, assuming the time from first medical contact to balloon inflation can be achieved in less than 90 min. In many areas, PCI hospitals have successfully collaborated with regional non-PCI hospitals to provide primary PCI for STEMI; however, significant variations exist in how these programs are executed. For example, the pre PCI hospital administration of antithrombotic agents by emergency medical personnel can include aspirin, clopidogrel, unfractionated heparin, low molecular weight heparin, partial or full dose fibrinolytics or combinations thereof. There is little consensus on the optimal cocktail, dose and route of administration. Standardizing the pre PCI antithrombotic regimen across hospital systems may be one approach to improve timely administration of these therapies, and potentially improve STEMI outcomes.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Antithrombotics & thrombolytics · Acetylsalicylic acid · P2Y12 inhibitors · Heparin · Thrombolytics
Related articles
- [Treatment of ST segment elevation myocardial infarctions according to the guidelines]. (Herz, 2005)
- The Strategic Reperfusion Early After Myocardial Infarction (STREAM) study. (Am Heart J, 2010)
- Reperfusion strategies in ST-elevation myocardial infarction--current status and perspectives for early and pre-hospital treatment. (Resuscitation, 2008)
- [Prehospital thrombolytic therapy with tenecteplase in patients with ST-elevation myocardial infarction]. (Kardiologiia, 2008)
- Preliminary experience with intravenous P2Y12 platelet receptor inhibition as an adjunct to reduced-dose alteplase during acute myocardial infarction: results of the Safety, Tolerability and Effect on Patency in Acute Myocardial Infarction (STEP-AMI) angiographic trial. (Am Heart J, 2007)
- Efficacy and safety of enoxaparin versus unfractionated heparin in patients with ST-segment elevation myocardial infarction also treated with clopidogrel. (J Am Coll Cardiol, 2007)