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Inferior ST-Elevation Myocardial Infarction Presenting When Urgent Primary Percutaneous Coronary Intervention Is Unavailable: Should We Adhere to Current Guidelines?
- Source :
- Cardiovascular Drugs and Therapy
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- The pivotal studies that led to the recommendations for emergent reperfusion therapy for ST-elevation myocardial infarction (STEMI) were conducted for the most part over 25 years ago. At that time, contemporary standard treatments including aspirin, statin, and even anticoagulation were not commonly used. The 2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines and the 2017 European Society of Cardiology guidelines give a class I recommendation (with the level of evidence A) for primary percutaneous coronary intervention (pPCI) in patients with STEMI and ischemic symptoms of less than 12 h. However, if the patient presents to a hospital without pPCI capacity, and it is anticipated that pPCI cannot be performed within 120 min of first medical contact, fibrinolytic therapy is indicated (if there are no contraindications) (class I indication, level of evidence A). Our review of the pertinent literature shows that the current recommendation for inferior STEMI is based on the level of evidence lower than A. We can consider level B even C, supporting the recommendation for fibrinolytic therapy if pPCI is not available for inferior STEMI.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
Statin
medicine.drug_class
medicine.medical_treatment
Inferior Wall Myocardial Infarction
Guidelines
030204 cardiovascular system & hematology
Risk Assessment
Time-to-Treatment
Fibrinolytic therapy
03 medical and health sciences
0302 clinical medicine
Reperfusion therapy
Risk Factors
St elevation myocardial infarction
medicine
Humans
Thrombolytic Therapy
Pharmacology (medical)
cardiovascular diseases
Myocardial infarction
Intensive care medicine
Aged
Pharmacology
Aspirin
business.industry
Percutaneous coronary intervention
General Medicine
Evidence-based medicine
medicine.disease
ST-elevation myocardial infarction
Treatment Outcome
030104 developmental biology
Invited Article
Practice Guidelines as Topic
ST Elevation Myocardial Infarction
Female
Guideline Adherence
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 15737241 and 09203206
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Cardiovascular Drugs and Therapy
- Accession number :
- edsair.doi.dedup.....3b32c60b31b67afac4c44660eba75a5b