title: Reperfusion strategies in ST-segment elevation myocardial infarction.
abstract: ST-elevation myocardial infarction (STEMI) is a major cause of morbidity and mortality worldwide. Emergent reperfusion of the infarct related artery is the cornerstone of STEMI treatment in order to salvage myocardium and improve cardiovascular outcome. Basically, reperfusion strategies include fibrinolysis, primary percutaneous coronary intervention (PCI) or the combination of both methods. Clinical studies indicate that primary PCI is superior to fibrinolytic therapy when performed rapidly at experienced centers. However, physicians are often faced with the decision to either accept PCI-related delays due to transfer or to administer fibrinolysis immediately. A well structured regional system of STEMI care helps to select the appropriate reperfusion strategy and guarantee timely restoration of coronary blood flow. This article reviews the evidence behind the respective reperfusion therapies and summarizes current guidelines for STEMI management.
authors.affiliation: Unit of Cardiology Department of Internal Medicine, Heart Center University of Leipzig, Leipzig, Germany - ingoeitel@gmx.de.
authors.forename: T
authors.initials: T
authors.lastname: Stiermaier
authors.forename: S
authors.initials: S
authors.lastname: Desch
authors.forename: G
authors.initials: G
authors.lastname: Schuler
authors.forename: H
authors.initials: H
authors.lastname: Thiele
authors.forename: I
authors.initials: I
authors.lastname: Eitel
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D009204:Myocardial Revascularization / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D015607:Stents; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors