Reperfusion options in ST-elevation myocardial infarction patients with expected delays

被引:3
作者
Larson D.M. [1 ]
Henry T.D. [1 ]
机构
[1] Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN 55407
关键词
Percutaneous Coronary Intervention; Acute Myocardial Infarction; Abciximab; Primary Percutaneous Coronary Intervention; STEMI Patient;
D O I
10.1007/s11886-008-0065-6
中图分类号
学科分类号
摘要
Primary percutaneous coronary intervention (PPCI) is the optimal reperfusion strategy for ST-elevation myocardial infarction (STEMI) patients when performed in a timely manner by experienced providers. Unfortunately, only 25% of US hospitals have percutaneous coronary intervention (PCI) capability. Transfer for PPCI has also been shown to improve outcomes if transfer times are short and PCI can be performed within 90 minutes. However, many STEMI patients cannot be transferred in a timely fashion because of long distances, adverse weather, or process-of-care delays. Recent data support strategies that combine fibrinolysis with transfer for PCI under these circumstances. The critical issue that is still debated is the timing of PCI (immediate vs delayed vs rescue). The significance of time to reperfusion to mortality is important but less critical for PCI than for fibrinolysis, but time still matters. To optimize time to reperfusion for STEMI patients, all hospitals need to have predetermined protocols in place based on hospital characteristics and proximity to a catheterization laboratory. © Current Medicine Group LLC 2008.
引用
收藏
页码:415 / 423
页数:8
相关论文
共 52 条
[1]  
Antman E.M., Hand M., Armstrong P.W., Et al., 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: Developed in collaboration With the Canadian Cardiovascular Society, Circulation, 117, pp. 296-329, (2008)
[2]  
Wennberg D.E., Lucas F.L., Siewers A.E., Et al., Outcomes of percutaneous coronary interventions performed at centers without and with onsite coronary artery bypass graft surgery, JAMA, 292, pp. 1961-1968, (2004)
[3]  
Nallamothu B.K., Bates E.R., Wang Y., Et al., Driving times and distances to hospitals with percutaneous coronary intervention in the United States: Implications for prehospital triage of patients with ST-elevation myocardial infarction, Circulation, 113, pp. 1189-1195, (2006)
[4]  
Terkelsen C.J., Lassen J.F., Norgaard B.L., Et al., Reduction of treatment delay in patients with ST-elevation myocardial infarction: Impact of pre-hospital diagnosis and direct referral to primary percutaneous coronary intervention, Eur Heart J, 26, pp. 770-777, (2005)
[5]  
Carstensen S., Nelson G.C.I., Hansen P.S., Et al., Field triage to primary angioplasty combined with emergency department bypass reduces treatment delays and is associated with improved outcome, Eur Heart J, 28, pp. 2313-2319, (2007)
[6]  
Le May M.R., So D.Y., Dionne R., Et al., A citywide protocol for primary PCI in ST-segment elevation myocardial infarction, N Engl J Med, 358, pp. 231-240, (2008)
[7]  
Dalby M., Bouzamondo A., Lechat P., Montalescot G., Transfer for primary angioplasty versus immediate thrombolysis in acute myocardial infarction: A meta-analysis, Circulation, 108, pp. 1809-1814, (2003)
[8]  
Nallamothu B.K., Bates E.R., Herrin J., Et al., Times to treatment in transfer patients undergoing primary percutaneous coronary intervention in the United States: National Registry of Myocardial Infarction (NRMI)-3/4 analysis, Circulation, 111, pp. 761-767, (2005)
[9]  
De Luca G., Suryapranata H., Ottervanger J.P., Antman E.M., Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: Every minute of delay counts, Circulation, 109, pp. 1223-1225, (2004)
[10]  
Reimer K.A., Lowe J.E., Rasmussen M.M., Jennings R.B., The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs, Circulation, 56, pp. 786-794, (1977)