Pre PCI hospital antithrombotic therapy for ST elevation myocardial infarction: striving for consensus

Strong evidence exists in favor of rapid transfer of a patient suffering an ST-elevation myocardial infarction (STEMI) to the nearest hospital with primary percutaneous coronary intervention (PCI) capability, assuming the time from first medical contact to balloon inflation can be achieved in less t...

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Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2012-07, Vol.34 (1), p.20-30
Main Authors: Gharacholou, S. Michael, Larson, Brenda J., Zuver, Christian C., Wubben, Ryan J., Gimelli, Giorgio, Raval, Amish N.
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary
Cardiology
Fibrinolytic Agents - therapeutic use
Hematology
Humans
Medicine
Medicine & Public Health
Myocardial Infarction - therapy
Preoperative Care - methods
Time Factors
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Summary:Strong evidence exists in favor of rapid transfer of a patient suffering an ST-elevation myocardial infarction (STEMI) to the nearest hospital with primary percutaneous coronary intervention (PCI) capability, assuming the time from first medical contact to balloon inflation can be achieved in less than 90 min. In many areas, PCI hospitals have successfully collaborated with regional non-PCI hospitals to provide primary PCI for STEMI; however, significant variations exist in how these programs are executed. For example, the pre PCI hospital administration of antithrombotic agents by emergency medical personnel can include aspirin, clopidogrel, unfractionated heparin, low molecular weight heparin, partial or full dose fibrinolytics or combinations thereof. There is little consensus on the optimal cocktail, dose and route of administration. Standardizing the pre PCI antithrombotic regimen across hospital systems may be one approach to improve timely administration of these therapies, and potentially improve STEMI outcomes.
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-012-0744-4