[Acute coronary syndromes with ST-segment elevation].
UNBLOCK THE CORONARY ARTERIES: For the treatment of acute coronary syndromes with ST-segment elevation, emergency repermeabilisation is of the artery is crucial, generally by primary angioplasty than by fibrinolysis. The other treatments have little beneficial effects on mortality. Primary angioplasty is the technique of choice when it can be performed in the intensive care units with staff with sufficient experience and within the 90 minutes following the preliminary medical management, and benefiting from the supply of PG IIb-IIIa. THROMBOLYSIS: Performed before the twelfth hour, thrombolysis reduces mortality. The earlier it is performed the greater the benefits. A significant reduction is mortality is observed even in patients aged over 75. The indications for coronography are determined by the existence of clinical risk factors and by the data of supplementary non-invasive examinations (sonography, scintigraphy, effort testing). When clinical risk factors exist from the start, a coronography must be performed. In the absence of initial risks, and if the non-invasive examination reveals risk factors, then a coronarography should be performed.
Genest
Marc
M
Service de cardiologie CH Provins, Provins. marc.genest@wanadoo.fr
Pochmalicki
Gilbert
G
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004452:Echocardiography; D004562:Electrocardiography; D004638:Emergency Treatment / Q000379:methods / Q000592:standards; D005080:Exercise Test; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D008981:Molsidomine / Q000627:therapeutic use; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014665:Vasodilator Agents; D008981:Molsidomine