TY - JOUR
T1 - What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?
AU - Curzen, Nicholas
AU - Gurbel, Paul A.
AU - Myat, Aung
AU - Bhatt, Deepak L.
AU - Redwood, Simon R.
N1 - Funding Information:
AM is supported by the Department of Health via the National Institute for Health Research comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust, in partnership with King's College London and King's College Hospital NHS Foundation Trust. AM acknowledges financial support from the British Heart Foundation via a Clinical Research Training Fellowship (grant number FS/11/70/28917 ). We thank Udaya Tantry (Sinai Center for Thrombosis Research, Baltimore, MD, USA) for providing us with the image for figure 1 .
Funding Information:
NC has received unrestricted research grants from Haemonetics, St Jude Medical, and Medtronic, and speaker and consultancy fees from Haemonetics, St Jude Medical, Abbott Vascular, Daichii-Sankyo, Boston Scientific, and Medtronic. PAG has consulted for Daiichi Sankyo, Lilly, Pozen, Novartis, Bayer, AstraZeneca, Accumetrics, Nanosphere, Sanofi-Aventis, Boehringher Ingelheim, Merck, Medtronic, Iverson Genetics, CSL, and Haemonetics, and has lectured or served on speakers' bureaus for Lilly, Daiichi Sankyo, Nanosphere, Sanofi-Aventis, Merck, and Iversen Genetics. DLB has served on the advisory boards of Elsevier PracticeUpdate (Cardiology), Medscape Cardiology, and Regado Biosciences; is on the board of directors of Boston VA Research Institute and the Society of Chest Pain Centers; has chaired the American Heart Association Get With The Guidelines steering committee; has received honoraria from the American College of Cardiology (served as Editor, Clinical Trials, CardioSource), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (served on the clinical trial steering committees), Population Health Research Institute (served on a clinical trial steering committee), Slack Publications (served as Chief Medical Editor, Cardiology Today's Intervention), WebMD (served on the CME steering committees); has served as Senior Associate Editor, Journal of Invasive Cardiology, and on the data monitoring committees of the COMPLETE (Complete versus culprit revascularisation in STEMI) and TOTAL (A randomised trial of routine aspiration thrombectomy with PCI versus PCI alone in patients with STEMI undergoing primary PCI) trials; has received research grants from Amarin, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Medtronic, Sanofi-Aventis, and The Medicines Company (co-Principal Investigator of the CHAMPION trials); and has done unfunded research for FlowCo, PLx Pharma, and Takeda. AM and SRR declare that they have no conflicts of interest.
PY - 2013
Y1 - 2013
N2 - Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key components of STEMI include formation of occlusive thrombus, mediation and ultimately amplification of the local vascular inflammatory response resulting in increased vasoreactivity, oedema formation, and microvascular obstruction. Activation, degranulation, and aggregation of platelets are the platforms from which these components develop. Therefore, prompt, potent, and predictable antithrombotic therapy is needed to optimise clinical outcomes after primary percutaneous coronary intervention. We review present pharmacological and mechanical adjunctive therapies for reperfusion and ask what is the optimum combination when primary percutaneous coronary intervention is used as the mode of revascularisation in patients with STEMI.
AB - Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key components of STEMI include formation of occlusive thrombus, mediation and ultimately amplification of the local vascular inflammatory response resulting in increased vasoreactivity, oedema formation, and microvascular obstruction. Activation, degranulation, and aggregation of platelets are the platforms from which these components develop. Therefore, prompt, potent, and predictable antithrombotic therapy is needed to optimise clinical outcomes after primary percutaneous coronary intervention. We review present pharmacological and mechanical adjunctive therapies for reperfusion and ask what is the optimum combination when primary percutaneous coronary intervention is used as the mode of revascularisation in patients with STEMI.
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U2 - 10.1016/S0140-6736(13)61453-1
DO - 10.1016/S0140-6736(13)61453-1
M3 - Review article
C2 - 23953387
AN - SCOPUS:84882252054
SN - 0140-6736
VL - 382
SP - 633
EP - 643
JO - The Lancet
JF - The Lancet
IS - 9892
ER -