Intracoronary compared with intravenous bolus abciximab application during primary percutaneous coronary intervention: Design and rationale of the Abciximab Intracoronary versus intravenously Drug Application in ST-Elevation Myocardial Infarction (AIDA STEMI) trial

2010 ◽  
Vol 159 (4) ◽  
pp. 547-554 ◽  
Author(s):  
Holger Thiele ◽  
Jochen Wöhrle ◽  
Petra Neuhaus ◽  
Oana Brosteanu ◽  
Peter Sick ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Drug Application ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Intervention Design ◽  
Intravenous Bolus ◽  
Percutaneous Coronary ◽  
St Elevation

Optimum Therapies for ST-Elevation Myocardial Infarction Managed with Primary Percutaneous Coronary Intervention

2012 ◽  
Vol 7 (2) ◽  
pp. 81
Author(s):  
Bruce R Brodie ◽  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Great Majority ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Stent Deployment ◽  
Aspiration Thrombectomy ◽  
Percutaneous Coronary ◽  
St Elevation

This article reviews optimum therapies for the management of ST-elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI). Optimum anti-thrombotic therapy includes aspirin, bivalirudin and the new anti-platelet agents prasugrel or ticagrelor. Stent thrombosis (ST) has been a major concern but can be reduced by achieving optimal stent deployment, use of prasugrel or ticagrelor, selective use of drug-eluting stents (DES) and use of new generation DES. Large thrombus burden is often associated poor outcomes. Patients with moderate to large thrombus should be managed with aspiration thrombectomy and patients with giant thrombus should be treated with glycoprotein IIb/IIIa inhibitors and may require rheolytic thrombectomy. The great majority of STEMI patients presenting at non-PCI hospitals can best be managed with transfer for primary PCI even with substantial delays. A small group of patients who present very early, who are at high clinical risk and have long delays to PCI, may best be treated with a pharmaco-invasive strategy.

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