title: Primary percutaneous coronary intervention in 'early' latecomers with ST-segment elevation acute myocardial infarction: the role of the infarct-related artery status.
abstract: A high proportion of patients with ST-segment elevation myocardial infarction (STEMI) are evaluated more than 12 h after symptom onset. In this setting, current guidelines suggest that mechanical reperfusion should be considered for patients with clinical and/or electrocardiographic evidence of ongoing ischaemia, re-infarction, cardiogenic shock, haemodynamic instability, or documented ejection fraction less than 40% and serious ventricular arrhythmias. Moreover, some adjunctive aspects like the stuttering course of acute myocardial infarction, the chance of an existing coronary collateral circulation, the ischaemic preconditioning and the infarct-related artery patency should be taken into consideration for patients with STEMI presenting from 12 to 72 h after symptom onset. These patients are known as 'early' latecomers. The aim of the present review is to summarize the current knowledge of the pathophysiology related to this topic and to suggest some new indications for primary percutaneous coronary intervention in 'early' latecomers.
authors.affiliation: Cardiovascular Department, S. Bortolo Hospital, Vicenza, Italy. fontanelli.cardiovi@ulssvicenza.itBack to Top
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fontanelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Bonanno
mesh_terms: D017130:Angioplasty; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006321:Heart / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D017410:Practice Guidelines as Topic; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents