Treatment of ST Elevation Myocardial Infarction from Fibrinolysis to Primary PCI: In Terms of Risks and Benefits.
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Date
2015
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Abstract
The treatment of ST elevation myocardial infarction (STEMI) has undergone significant advances
over the past three decades. Current practice guidelines raise the importance of promptly restoring
normal coronary blood flow and myocardial perfusion in the infarct zone after the onset of chest
pain, through either pharmacologic or mechanical reperfusion strategies.
Fibrinolytic therapy remains the most widely used reperfusion strategy worldwide. With the
development of newer fibrinolytic agents and adjuvant potent anti-platelets therapies, this approach
carries an increased risk of bleeding complications. The current research present up-date review of the use of reperfusion strategies for the treatment of STEMI, using data through the search of
MEDLINE, PubMed, EMBASE, as well as related extracts from the annual report of the American
Heart Association, the American College of Cardiology, and the European Society of Cardiology.
We summarized data from the available studies conducted over the past last 30 years in relation to
pharmacologic reperfusion therapy in regards to risks and benefits.
Conclusion: Fibrinolytic therapy remains the main reperfusion strategy used for the treatment of
STMI worldwide. In the current era, there is a lack of fibrinolytic therapy trials, mainly because of
increased focus in mechanical reperfusion therapies’ studies in the developed world. Clinical trials
on the use of the fibrinolytics with newer platelet agents are urgently needed.
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Keywords
Fibrinolytic agents, streptokinase, retaplase, alteplase, tenecteplase, acute myocardial infarction, patency rate, bleeding, intracranial hemorrhage
Citation
Khafaji Hadi A R Hadi, Al-Suwaidi Jassim M. Treatment of ST Elevation Myocardial Infarction from Fibrinolysis to Primary PCI: In Terms of Risks and Benefits. Cardiology and Angiology An International Journal. 2015; 3(1): 40-77.