What is reperfusion therapy and guidelines?
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?
PPCI is the preferred reperfusion strategy in patients experiencing STEMI.
What should be included in reperfusion strategy?
Selecting the optimal reperfusion strategy requires customization based on patient factors including time from symptom onset to first medical contact (FMC), the amount of myocardium at risk, the presence of shock or severe heart failure, the risk of bleeding with fibrinolysis, and the time required to perform PCI ( …
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.
How do you treat 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).
What is the gold standard treatment for STEMI?
Direct percutaneous recanalization of the infarct-related artery represents the gold standard in treating STEMI, specifically when performed within two hours after first medical contact.
What is the goal for PCI when treating a STEMI patient?
In the setting of acute ST-elevation myocardial infarction (STEMI), the primary goal of percutaneous coronary intervention (PCI) or fibrinolysis is to reestablish patency of the affected coronary artery and thereby improve perfusion of the myocardium.
How do you treat reperfusion injury?
Ischemia reperfusion injury has been treated using several therapeutic gases, including hydrogen (H2), hydrogen sulfide (H2S), NO, and carbon monoxide (CO). 50 , 51 Carbon monoxide, one of the byproducts of the heme oxygenase system, can provide cytoprotection by modulating intracellular signaling pathways through its …
What rhythm is common after reperfusion therapy?
Reperfusion arrhythmias are common in patients undergoing percutaneous coronary intervention (also after thrombolysis and coronary artery bypass graft), including accelerated idioventricular rhythms, ventricular tachycardia, and ventricular fibrillation.
What is primary PCI in STEMI?
Primary percutaneous coronary intervention (PCI) refers to the strategy of taking a patient who presents with STEMI directly to the cardiac catheterization laboratory to undergo mechanical revascularization using balloon angioplasty, coronary stents, aspiration thrombectomy, and other measures.