Evolution in treatment of ST-segment elevation myocardial infarction
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
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Type: Reviews
DOI:
For citation: Efendieva A.S., Bulaeva N.I., Golukhova E.Z. Evolution in treatment of ST-segment elevation myocardial infarction. Creative Cardiology. 2023; 17 (2): 203–16 (in Russ.). DOI: 10.24022/1997-3187-2023-17-2-203-216
Received / Accepted: 03.04.2023 / 27.06.2023
Keywords: acute myocardial infarction ischemic heart disease percutaneous coronary intervention antiplatelet therapy
Abstract
Coronary heart disease (CHD) occupies a leading position among all causes of death, while the maximum mortality is observed in myocardial infarction (MI) with the ST-segment elevation. Understanding the pathophysiology of MI revolutionized the approach to treatment with the consistent use of thrombolytic therapy, the development of optimal antiplatelet therapy, surgical coronary revascularization and percutaneous coronary intervention (PCI) with primary coronary angioplasty and intracoronary stent placement. It became clear that the timing of revascularization plays a key role and influence on the favorable outcome, and a clear relationship was traced between the time of ischemia and the size of myocardial infarction. As the result there was established the principle of the “golden hour”, which was later confirmed by multiple randomized trials. With the implementation of the recommendations and strict observance of all time intervals, the effectiveness of medical care for patients with acute MI in recent years has exceeded 80%.References
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