Implementation of reperfusion therapy in ST-segment elevation myocardial infarction. A policy statement from the Belgian Society of Cardiology (BSC), the Belgian Interdisciplinary Working Group on Acute Cardiology (BIWAC) and the Belgian Working Group on Interventional Cardiology (BWGIC).

摘要

Acute heart attacks are a major healthcare problem with continuing high mortality and morbidity rates. The major goal in the treatment of acute myocar-dial infarction (AMI) is the rapid restoration of blood flow and myocardial perfusion in the infarct zone. This can be achieved by either a pharmacological approach (fibrinolysis) or by a mechanical approach (immediate coronary angiography and coronary dilatation of the occluded infarct artery, the so-called primary percutaneous coronary intervention or PCI). A timely application of reperfusion therapy has been shown to influence favourably short- and long-term patient outcome. Data from several large registries have, however, shown that reperfusion therapy is insufficiently implemented in many countries1. A considerable number of patients with ST-segment elevation myocardial infarction (STEMI) do not receive any reperfusion therapy, for a wide variety of reasons, despite its availability and the absence of any contra-indication. In addition, for patients who do have access to reperfusion, pre- or in-hospital delays can adversely influence the outcome.