title: Recent advances in the management of acute myocardial infarction.
abstract: Recently the reperfusion therapy in the form of Primary Percutaneous Coronary intervention (PPCI) has become the gold standard for the treatment of Acute Myocardial Infarction. In spite of rapid revascularization either with PPCI or thrombolytic therapy, the significant number of patients develops decreased left ventricular function leading to heart failure which can increase long-term mortality and morbidity. The number of strategies are being evolved and evaluated to reduce this post infarct heart failure. They are being developed at the level of optimizing the outcomes of PPCI, protection against the reperfusion injury, and novel therapies like cardiac repair and regeneration and sonothrombolysis. Thrombus aspiration using simple aspiration catheters during PPCI are getting established as a useful adjunct tool to reduce distal embolisation and consequently improving myocardial salvage. The newer antiplatelet drugs like Prasugrel and Ticagrelor may replace the Clopidogrel to reduce ischemic complications. The reduction in reperfusion injury using drugs has shown mixed results. The newer modalities like cardiac repair and regeneration using stem cell therapy looks promising but are yet to be established.
authors.affiliation: Spandan Heart Institute & Research Center, Nagpur.
authors.forename: H M
authors.initials: HM
authors.lastname: Mardikar
authors.forename: N V
authors.initials: NV
authors.lastname: Deshpande
authors.forename: Parag
authors.initials: P
authors.lastname: Admane
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019468:Disease Management; D006801:Humans; D019194:Ischemic Preconditioning; D009203:Myocardial Infarction / Q000188:drug therapy / Q000628:therapy*; D015425:Myocardial Reperfusion; D033581:Stem Cell Transplantation; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents