What is reperfusion therapy for STEMI?
Reperfusion therapy is a medical treatment to restore blood flow, either through or around, blocked arteries, typically after a heart attack (myocardial infarction (MI)). Reperfusion therapy includes drugs and surgery. The drugs are thrombolytics and fibrinolytics used in a process called thrombolysis.
What primary reperfusion treatment is preferred for a patient with an acute STEMI who is not a candidate for cardiac catheterization?
Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction (STEMI) when it can be performed expeditiously and by experienced operators.
What is the preferred treatment for STEMI?
Treatment – STEMI Medical Therapy. Initial medical therapy during STEMI consists of oxygen administration, antiplatelet therapy (aspirin, thienopyridines and glycoprotein IIb/IIIa inhibitors), anticoagulation (heparin or bivalirudin), anginal pain relief with nitrates and morphine, and beta-blockade.
What is the door to reperfusion time in a STEMI patient?
In patients with ST‐segment–elevation myocardial infarction, timely reperfusion therapy with door‐to‐balloon (D2B) time <90 minutes is recommended by current guidelines. The current study showed that there was continuous association between shortening D2B time and reduced risk of 1‐year mortality.
What are the adverse effects of fibrinolytic therapy?
Adverse Effects and Contraindications Common adverse effects of all the thrombolytic drugs is bleeding complications related to systemic fibrinogenolysis and lysis of normal hemostatic plugs. The bleeding is often noted at a catheterization site, although gastrointestinal and cerebral hemorrhages may occur.
Why are thrombolytics used in STEMI?
Fibrinolytic therapy, also known as thrombolytic therapy, is used to lyse acute blood clots by activating plasminogen, resulting in the formation of plasmin, which cleaves the fibrin cross-links causing thrombus breakdown.
How do you stop a STEMI?
The priority in treating a STEMI heart attack is to open the artery quickly, saving as much heart muscle as possible. Treatment options include percutaneous coronary intervention (PCI), a term that encompasses both angioplasty and stenting; clot-busting medication; and coronary artery bypass graft surgery (CABG).
How quickly should a patient presenting to EMS with STEMI get to the cath lab?
National ACC/American Heart Association (AHA) guidelines state that hospitals treating STEMI patients with emergency percutaneous coronary interventions (PCI) should reliably achieve a door-to-balloon time (D2B) of 90 minutes or less, and studies have demonstrated strong associations between time to primary PCI and in- …
What is door-to-needle time in STEMI?
Current guidelines for STEMI recommend a door-to-needle time within 30 minutes for fibrinolytic therapy and a door-to-balloon time within 90 minutes for primary PCI as treatment goals.
Who is eligible for reperfusion therapy for STEMI?
This guideline is intended for health care providers working in EDs. This guideline is intended for adult patients presenting to the ED with suspected acute STEMI. This guideline is not intended for pediatric patients, pregnant patients, or patients with contraindications to fibrinolytic treatment.
What should I take with reperfusion therapy for PCI?
All patients undergoing reperfusion therapy for STEMI (PCI or fibrinolysis) should be given dual anti-platelet therapy (DAPT, aspirin and an ADP blocker, commonly aspirin and clopidogrel) unless contraindicated.30,33 Aspirin is one of the most significant and cost-effective treatments for STEMI.
Which is better PCI or fibrinolytic therapy for STEMI?
Primary PCI is preferred for reperfusion therapy in patients with STEMI if it can be performed within 90 minutes of first medical contact If this time frame is not possible, then fibrinolytic therapy is preferred for those without contraindications.
When to use door to needle for STEMI Reperfusion?
Door-to-needle time may be a quicker way to reperfusion even when primary PCI capabilities exist at the hospital. FT may also be advantageous from the standpoint of resource utilization and protection of essential health care staff such as cath teams.
