[Controversies in the treatment of acute myocardial infarction].
The primary angioplasty in the acute infarction is a documented and applied therapy in nearly 80% of the acute infarction in Switzerland. The usual pharmacological approach can be associated to a thrombo-aspiration at the beginning of the procedure, with a probable benefit on the final coronary flow and a reduction in the risk of "no reflow" (TAPAS study). The selection of a bare metal stent is a consensus established for one decade. The recent meta-analyses of Pasceri and Kastrati have shown at one year, a rate of stent thrombosis, similar among patients treated by a bare metal stent or a drug eluting stent, but with a net benefit on the risk of reintervention for restenosis at mid-term when an eluting stent is implanted.
Noble
Jacques
J
Service de cardiologie, Département de médecine interne HUG, 1211 Genève 14. noblej@iprolink.ch
Urban
Philip
P
D015906:Angioplasty, Balloon, Coronary; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D015607:Stents; D017131:Thrombectomy