Acute ST-segment myocardial infarction-evolution of treatment strategies

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2013

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Wong, D.T.
Puri, R.
Psaltis, P.J.
Worthley, S.G.
Worthley, M.I.

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World Journal of Cardiovascular Diseases, 2013; 03(09):551-560

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Dennis T. L. Wong, Rishi Puri, Peter J. Psaltis, Stephen G. Worthley, Matthew I. Worthley

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Abstract

The commonest cause of acute myocardial infarction involves the rupture or erosion of vulnerable athero- sclerotic plaques followed by aggregation of platelets and subsequent thrombus formation, leading to par- tial or complete epicardial coronary arterial occlusion. Over the last 25 years, advancement in therapeutic options for acute myocardial infarction has resulted in substantial improvement in morbidity and mortal- ity. As a result, the absolute risk reduction of in-hos- pital deaths for patients presenting with STEMI has been on the decline in the last decade. The focus of the treatment for acute myocardial infarction invol- ves achieving epicardial and microvascular patency, prevention of recurrent ischaemic events while bal- ancing the risk of bleeding. This involves antiplatelet and antithrombotic therapies or fibrinolytic agents when timely performance of primary percutaneous coronary intervention is not possible. We review the evolution of treatment strategies for STEMI that has contributed to the improvement in patient outcome.

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Copyright © 2013 Dennis T. L. Wong et al. This is an open access article distributed under the Creative Commons Attribution Li- cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights © 2013 are reserved for SCIRP and the owner of the intel-lectual property Dennis T. L. Wong et al. All Copyright © 2013 are guarded by law and by SCIRP as a guardian.

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