Featured Research

from universities, journals, and other organizations

Personalizing revascularization strategy for STEMI patients is vital

Date:
May 21, 2014
Source:
European Society of Cardiology (ESC)
Summary:
The role of the two most valuable strategies to save the lives of ST-segment Elevation Myocardial Infarction (STEMI) patients has been a hot topic among experts of late: primary percutaneous coronary intervention (PCI) versus thrombolysis. Both of these are effective treatments that actively save lives, and when there is no option for primary percutaneous coronary intervention, thrombolysis is the way to proceed, they have now agreed.

A "Great Debate" at EuroPCR 2014 saw experts discussing the role of the two most valuable strategies to save the lives of ST-segment Elevation Myocardial Infarction (STEMI) patients: primary percutaneous coronary intervention (PCI) and thrombolysis.

Both of these are effective treatments that actively save lives, and when there is no option for primary percutaneous coronary intervention, thrombolysis is the way to proceed, participants heard. The topic of the Great Debate, 'Primary PCI for STEMI: an emergency!' was selected ahead of the session by the interventional cardiology community, according to a vote on the EuroPCR website.

Thomas Cuisset, University Hospital, Marseille, France, noted that the goal of the session was to highlight the current clinical issues with the optimisation of primary PCI, and discuss the specifics of the technique, devices and adjunctive pharmacology.

"The spirit and core of the session was interaction between the facilitators and audience who sent in their questions throughout the session. Within this, we sought to highlight that primary PCI has to be a personalised intervention. Within the 'STEMI box', we are dealing with very different patients, so the choice of drugs, vascular access and use (or not) of thromboaspiration, needs to be tailored to fit the patient," he said.

The final goal in STEMI is early revascularisation and, in some geographies, for various reasons, primary PCI is delayed and therefore a pharmacoinvasive strategy can be a good alternative in such areas, the panel agreed.

Sajidah Khan, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, emphasised that the efforts for treating STEMI comes from the recognition that the biggest impact on survival depends on establishing reperfusion within the first three hours of the onset of chest pain.

"The most powerful method of reducing mortality is to use whatever method you have at hand to treat the patient within three hours, because that is the window of greatest opportunity for treatment to impact on survival and outcomes," she said.

Khan noted that interventional cardiologists recognise that primary percutaneous coronary intervention was the best way to open the artery, ie. the gold standard. However, she pointed out that in resourced-limited environments where the availability of cath labs and interventional cardiologists could be a challenge, alternative strategies such as thrombolysis had a place in the treatment options.

"It is very reassuring for those of us who work in resource-scarce environments, that thrombolysis, if given correctly, is shown to be equivalent to PCI. However, we have to be cautious about the bleeding risk, particularly in the elderly. In those over 75, the benefit of primary PCI clearly outshines thrombolysis. In the developing world, we see that the age of the patient presenting with ST elevation is much younger and it is reassuring to know that the risk of bleeding from thrombolysis is lower in this population," she said.

Research shows that the bulk of mortality from coronary artery disease is shifting to middle and low income countries where access to cath labs may be limited, Khan said. She also pointed out that the need for research that compares the outcomes of thrombolysis with PCI, in countries that have widespread access to cath labs, has been interesting to see. "This points to the fact that merely having the access to the cath lab does not necessarily translate to every patient reaching the lab and undergoing revascularisation within three hours," she said.


Story Source:

The above story is based on materials provided by European Society of Cardiology (ESC). Note: Materials may be edited for content and length.


Cite This Page:

European Society of Cardiology (ESC). "Personalizing revascularization strategy for STEMI patients is vital." ScienceDaily. ScienceDaily, 21 May 2014. <www.sciencedaily.com/releases/2014/05/140521133310.htm>.
European Society of Cardiology (ESC). (2014, May 21). Personalizing revascularization strategy for STEMI patients is vital. ScienceDaily. Retrieved September 16, 2014 from www.sciencedaily.com/releases/2014/05/140521133310.htm
European Society of Cardiology (ESC). "Personalizing revascularization strategy for STEMI patients is vital." ScienceDaily. www.sciencedaily.com/releases/2014/05/140521133310.htm (accessed September 16, 2014).

Share This



More Health & Medicine News

Tuesday, September 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com
Man Floats for 31 Hours in Gulf Waters

Man Floats for 31 Hours in Gulf Waters

AP (Sep. 16, 2014) A Texas man is lucky to be alive after he and three others floated for more than a day in the Gulf of Mexico when their boat sank during a fishing trip. (Sept. 16) Video provided by AP
Powered by NewsLook.com
Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

AFP (Sep. 16, 2014) Since the arrival of Ebola in Ivory Coast, Ivorians have been abandoning their pets, particularly monkeys, in the fear that they may transmit the virus. Duration: 00:47 Video provided by AFP
Powered by NewsLook.com
Study Links Male-Pattern Baldness To Prostate Cancer

Study Links Male-Pattern Baldness To Prostate Cancer

Newsy (Sep. 16, 2014) New findings suggest men with a certain type of baldness at age 45 are 39 percent more likely to develop aggressive prostate cancer. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

      Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins