TITLE:
Acute ST-segment myocardial infarction—Evolution of treatment strategies
AUTHORS:
Dennis T. L. Wong, Rishi Puri, Peter J. Psaltis, Stephen G. Worthley, Matthew I. Worthley
KEYWORDS:
Myocardial Infarction; STEMI; PCI; Coronary Artery Intervention
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.9,
December
17,
2013
ABSTRACT: The commonest cause of acute
myocardial infarction involves the rupture or erosion of vulnerable atherosclerotic
plaques followed by aggregation of platelets and subsequent thrombus formation,
leading to partial or complete epicardial coronary arterial occlusion. Over the
last 25 years, advancement in therapeutic options for acute myocardial
infarction has resulted in substantial improvement in morbidity and mortality.
As a result, the absolute risk reduction of in-hospital deaths for patients
presenting with STEMI has been on the decline in the last decade. The focus of
the treatment for acute myocardial infarction involves achieving epicardial and
microvascular patency, prevention of recurrent ischaemic events while balancing
the risk of bleeding. This involves antiplatelet and antithrombotic therapies
or fibrinolytic agents when timely performance of primary percutaneous coronary
intervention is not possible. We review the evolution of treatment strategies
for STEMI that has contributed to the improvement in patient outcome.