What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?

Nicholas Curzen, Paul A. Gurbel, Aung Myat, Deepak L. Bhatt, Simon R. Redwood

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)633-643
Number of pages11
JournalThe Lancet
Volume382
Issue number9892
DOIs
StatePublished - 2013

ASJC Scopus subject areas

  • Medicine(all)

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