PMID- 24622447
OWN - NLM
STAT- MEDLINE
DCOM- 20150202
LR  - 20181202
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 127
IP  - 6
DP  - 2014
TI  - State of the art contemporary treatment of patients with ST elevation myocardial 
      infarction: pre- and in-hospital organization, devices and drugs.
PG  - 1133-40
AB  - OBJECTIVE: To review the presentation, diagnosis and recent developments in the 
      pharmacological and invasive treatment of ST elevation myocardial infarction 
      (STEMI) with a special focus on health-care organization in order to increase 
      accessibility of primary percutaneous coronary intervention (PCI). DATA SOURCES: 
      Data were obtained from English publications on STEMI treatment. No formal 
      systematic review was conducted, but an effort was made to be comprehensive. 
      STUDY SELECTION: Studies were selected if they contained data relevant to the 
      topic. Preferably, data from clinical randomized trials, meta-analyses, 
      guidelines and a few recent reviews are referenced. RESULTS: The described 
      clinical approach to acute myocardial infarction (AMI) has been a continuum of 
      scientific results and translation into clinical practice over the last four 
      decades since the advent of thrombolytic reperfusion. This has resulted in a 
      dramatic in-hospital mortality decrease from 30% in the 1960s to the present 5%. 
      The biggest survival benefits have undoubtedly been achieved after the advent of 
      reperfusion strategies. In contemporary treatment of STEMI, additional treatment 
      effects on survival have to be sought in the very early admission phase, as the 
      current mortality hazard drops significantly after the first critical days to 
      continuously very low levels after discharge. CONCLUSIONS: Optimal treatment of 
      STEMI patients is best performed with a widely accessible reperfusion strategy, 
      preferably primary PCI, with contemporary peri-procedural anti-thrombotic 
      treatment and device implantation. Accessibility of reperfusion strategies is 
      increased by efficient STEMI networks applying prehospital triage with digital 
      tele-transmission of electrocardiograms (ECGs) and seamless patient transitions 
      between health-care unities. Efficient treatments of complicated STEMI with 
      out-of hospital cardiac arrest and/or cardiogenic shock underline the necessity 
      of structured referral systems, preferably immediately after the initial STEMI 
      diagnosis.
FAU - Schoos, Mikkel Malby
AU  - Schoos MM
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of 
      Medicine at Mount Sinai, New York, NY 10029-6574, USA.
FAU - Mehran, Roxana
AU  - Mehran R
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of 
      Medicine at Mount Sinai, New York, NY 10029-6574, USA. Email: 
      Roxana.mehran@mountsinai.org.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Drug-Eluting Stents
MH  - Humans
MH  - Myocardial Infarction/*drug therapy/*surgery
MH  - Thrombolytic Therapy/methods
EDAT- 2014/03/14 06:00
MHDA- 2015/02/03 06:00
CRDT- 2014/03/14 06:00
PHST- 2014/03/14 06:00 [entrez]
PHST- 2014/03/14 06:00 [pubmed]
PHST- 2015/02/03 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2014;127(6):1133-40.