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Non-pharmacological treatment of AMI – present status and future prospects


Authors: MUDr. Petr Kala, Ph.D. FESC.
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno kalapetr@yahoo. com
Published in: Kardiol Rev Int Med 2008, 10(Mimořádné): 29-32

Overview

Primary coronary intervention (primary PCI) is the best treatment modality of the patients with ST-elevation acute myocardial infarction. At present another technique can be used for further improvement of the results – thromboaspiration. TAPAS trial is the first study documented not just the acute better results of the primary PCI on microcirculation but at the same time the lower mortality and recurrence of myocardial infarction rate were observed during 1-year follow-up. According to the huge metaanalysis of the trials and registries using the drug-eluting and bare-metal stents the use of drug-eluting stents seems to be not just safe but also more effective in long-term follow-up. But there is a permanent need for strict controle of the risk factors of atherosclerosis and its prevention.

Key words

Acute myocardial infarction – primary PCI – non-pharmacological treatment – drug-eluting stents


Sources

1. Widimsky P, Groch L, Zelizko M et al. Multicentre randomized trial comparing transport to primary angioplasty vs immediate thrombolysis vs combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE study. Eur Heart J 2000; 21(10): 823-831.

2. Widimsky P, Budesinsky T, Vorac D et al. Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction. Final results of the randomized national multicentre trial - PRAGUE-2. Eur Heart J 2003; 24(1): 94-104.

3. Svilaas T, Vlaar PJ, van der Horst IC et al. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med 2008; 358(6): 557-567.

4. Laarman GJ, Suttorp MJ, Dirksen MT et al. Paclitaxel-eluting versus uncoated stents in primary percutaneous coronary intervention. N Engl J Med 2006; 55: 1105-1113.

5. Spaulding C, Henry P, Teiger E et al. TYPHOON Investigators. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med 2006; 55: 1093-1104.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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