title: Evaluation and management of special subgroups after primary percutaneous coronary intervention.
abstract: In recent decades, the increased use of novel pharmacologic therapies and primary percutaneous coronary intervention has considerably improved survival in the setting of ST-segment elevation myocardial infarction. Nevertheless, optimal management and care of particular subgroups of patients such as the elderly and individuals with diabetes mellitus, renal dysfunction, or cardiogenic shock are still debated. In fact, because of their clinically relevant comorbidities, these patients are often excluded from randomized trials; thus, data are largely limited to those from retrospective cohorts or subgroup analyses of large clinical studies. These particular subgroups of patients require special management during and after prompt mechanical reperfusion because of their high risk of both thrombotic and bleeding events. Therefore, cardiologists should accurately assess the risk-benefit equation before administrating and dosing currently available antithrombotic and antiplatelets agents in these high-risk populations.
authors.affiliation: Interventional Cardiology Unit, Department of Cardiovascular Sciences, European Hospital, Rome, Italy. leo.deluca@libero.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tomai
authors.forename: Monica
authors.initials: M
authors.lastname: Verdoia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
mesh_terms: D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002317:Cardiovascular Agents / Q000627:therapeutic use; D048909:Diabetes Complications; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006353:Heart-Assist Devices; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000150:complications* / Q000628:therapy
chemical_list: D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors