Interventional procedures in acute myocardial infarction.
Acute myocardial infarction (AMI) is a leading cause of death in the western world. Primary percutaneous intervention (PCI) has emerged as an effective therapy that may improve survival and decrease morbidity in patients with AMI. Our article discusses the advantages of PCI over thrombolytic therapy and reviews currently available techniques. Rescue angioplasty, adjunctive pharmacologic therapies, economic and feasibility considerations are also discussed. Emerging therapies are also addressed. Evidence supports the first-line use of PCI for AMI. Furthermore, primary PCI appears superior to thrombolytic therapy for AMI in many patient populations, especially the elderly, patients with prior coronary artery bypass surgery, patients with congestive heart failure and in patients with cardiogenic shock. Advancements in equipment and techniques and emerging adjunctive therapies will continue to enhance this therapy and improve its efficacy.
Kostur
M R J
MR
Department of Internal Medicine, Keesler Air Force Medical Center, Biloxi, MS 39534, USA.
Degeare
V S
VS
D015906:Angioplasty, Balloon, Coronary; D017073:Atherectomy; D005544:Forecasting; D006801:Humans; D009203:Myocardial Infarction / Q000191:economics / Q000628:therapy*; D018579:Patient Selection; D015607:Stents; D015912:Thrombolytic Therapy