[Actual clinical practice of guideline-recommended therapy of acute ST elevation myocardial infarction].
Treatment of acute ST elevation myocardial infarction (STEMI) is based on early reperfusion therapy (primary PCI [percutaneous coronary intervention], thrombolysis) and adjunctive medical therapy. Primary PCI is recommended as the therapy of first choice in the German guidelines, if the delay by a transfer to primary PCI versus thrombolysis is <or=90 min. Actual treatment of STEMI in clinical practice was analyzed by the Ludwigshafen myocardial infarction registries. The Ludwigshafen myocardial infarction registries are prospective multicenter registries including approximately 60,000 consecutive patients in the last 13 years. The mean prehospital delay of STEMI patients in Germany is 190 min. To reduce this critical time delay, intensive and continuous education of the patients is necessary. The rate of early reperfusion therapy of STEMI patients in Germany is 60-70%; especially the rate of primary PCI clearly increased in comparison to former published data. Patients without reperfusion therapy have a very high mortality. Physicians therefore should try to further improve the rate of early reperfusion therapy in STEMI patients. Medical adjunctive treatment should be used to a high dose in every STEMI patient without individual contraindications.
Wienbergen
Harm
H
Herzzentrum, Medizinische Klinik B, Institut für Herzinfarktforschung, Ludwigshafen. wienberh@klilu.de
Gitt
Anselm K
AK
Senges
Jochen
J
D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011379:Prognosis; D012042:Registries; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents