Current and novel approaches to treat patients presenting with ST elevation myocardial infarction.
BACKGROUND
Primary percutaneous coronary intervention (PCI) represents the gold-standard treatment for patients presenting with an ST-elevation myocardial infarction (STEMI). Acute myocardial infarction is a complex clinical scenario, and an appropriate therapeutic approach could be represented by a balanced integration between healthcare system and medical competence.


METHODS
In this review we discuss how a primary PCI network, and the new therapeutic options could be coupled in order to obtain improved clinical outcomes. The present report will focus on three main issues related to STEMI patients, namely, out of hospital management, primary PCI and pharmacological treatment. Expert commentary: A possible correct approach to a patient presenting a STEMI could be considered as a stepwise process, given by 5 steps: reducing the time to reperfusion; dual antiplatelet administration; radial access; new generation drug eluting stent implantation; long term management.
a Department of Interventional Cardiology , Thoraxcenter, Erasmus MC , Rotterdam , The Netherlands.
Massimo
M
Mancone
a Department of Interventional Cardiology , Thoraxcenter, Erasmus MC , Rotterdam , The Netherlands.
Nicolas M
NM
van Mieghem
a Department of Interventional Cardiology , Thoraxcenter, Erasmus MC , Rotterdam , The Netherlands.
Felix
F
Zijlstra
a Department of Interventional Cardiology , Thoraxcenter, Erasmus MC , Rotterdam , The Netherlands.
Roberto
R
Diletti
D015906:Angioplasty, Balloon, Coronary; D054855:Drug-Eluting Stents; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy*; D016896:Treatment Outcome
STEMI; dual antiplatelet therapy; manual thrombectomy; primary PCI; radial approach; thrombolysis