What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?

Published

Journal Article (Review)

Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key components of STEMI include formation of occlusive thrombus, mediation and ultimately amplification of the local vascular inflammatory response resulting in increased vasoreactivity, oedema formation, and microvascular obstruction. Activation, degranulation, and aggregation of platelets are the platforms from which these components develop. Therefore, prompt, potent, and predictable antithrombotic therapy is needed to optimise clinical outcomes after primary percutaneous coronary intervention. We review present pharmacological and mechanical adjunctive therapies for reperfusion and ask what is the optimum combination when primary percutaneous coronary intervention is used as the mode of revascularisation in patients with STEMI.

Full Text

Duke Authors

Cited Authors

  • Curzen, N; Gurbel, PA; Myat, A; Bhatt, DL; Redwood, SR

Published Date

  • August 2013

Published In

Volume / Issue

  • 382 / 9892

Start / End Page

  • 633 - 643

PubMed ID

  • 23953387

Pubmed Central ID

  • 23953387

Electronic International Standard Serial Number (EISSN)

  • 1474-547X

International Standard Serial Number (ISSN)

  • 0140-6736

Digital Object Identifier (DOI)

  • 10.1016/s0140-6736(13)61453-1

Language

  • eng