title: Continuum of care in the treatment of ST-segment elevation myocardial infarction (STEMI): importance of platelet and coagulation inhibition.
abstract: ST-segment elevation myocardial infarction (STEMI) is a serious manifestation of atherothrombosis. Platelets play an important role in the pathogenesis of atherothrombosis, and the use of antiplatelet agents is associated with substantial improvements in clinical outcome. Current guidelines for the management of patients with STEMI stress the importance of using antiplatelet agents as an integral part of acute and long-term therapy. However, these and other recommended therapies are frequently underutilized. In-hospital quality improvement initiatives have been shown to substantially improve adherence to guideline-recommended therapies at the time of discharge. This review discusses the role of platelets in atherothrombosis and describes the medical management of patients with STEMI, highlighting current guideline recommendations, adherence in clinical practice, and the impact of quality improvement programs in maintaining the continuum of care into the ambulatory setting.
authors.affiliation: Division of Cardiovascular Medicine, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC 27710, USA. roe00001@mc.duke.edu
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.forename: George
authors.initials: G
authors.lastname: Kikano
authors.forename: Chadwick D
authors.initials: CD
authors.lastname: Miller
authors.forename: James W
authors.initials: JW
authors.lastname: Hoekstra
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D003328:Coronary Thrombosis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors