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外科研究与新技术 ›› 2012, Vol. 1 ›› Issue (1): 76-80.

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ST-segment elevation myocardial infarction; reperfusion treatment; percutaneous coronary intervention

Jongo S.A, Xu Ya-Wei   

  1. Department of Cardiology,Shanghai Tenth People’s Hospital,Tongji University,Shanghai 200072,China
  • Online:2012-09-28 Published:2012-01-25

Abstract: ST segment elevation myocardial infarction (STEMI) is a major health concern even with the current improvements in diagnosing and managing acute MI.STEMI is still a fatal event in approximately 33% of patients.STEMI is only the second most severe form of acute coronary syndrome (ACS) after sudden cardiac death.About 29% of patients with myocardial infarction experience a STEMI (1),whereas 47% of acute coronary syndrome (ACS) patients present with STEMI (2).STEMI is one of the three components which constitute a spectrum of conditions known as acute coronary syndrome (ACS),the other two being unstable angina and Non-ST segment elevation myocardial infarction (NSTEMI).Acute coronary syndrome is characterized by a specific pattern of acute ischemic chest pain (either rest pain or minimal exertion),associated with ECG changes of ischemia (ST elevation or depression or T inversion).The presence of persistent ST elevation distinguishes STEMI from other forms of acute coronary syndrome.NSTEMI and unstable angina are distinguished by the presence or absence of a rise in cardiac injury markers[3-6].Fibrinolysis and percutaneous coronary intervention (PCI),are the definitive therapies for reperfusion in STEMI.These strategies have been on a frontline to improve patency of the infarct-related artery,reduce infarct size,and lower mortality rates.The time sensitivity nature of STEMI prompts for a quick implementation of one or the other of these two strategies[4-7].Surveys showed that many patients with STEMI from western countries remain “untreated” with limited access to reperfusion therapy and suboptimal utilization of proven pharmacotherapies in clinical practices.Up to one-third of patients presenting with STEMI within 12 h of symptom onset still receive no reperfusion therapy acutely,despite improvements in care[7-8].However,a recent study has shown that,80.9% of patients with STEMI in Beijing received reperfusion treatment (81% primary PCI; 19% thrombolysis).Meanwhile,the study implies that primary PCI was the predominant reperfusion strategy in Beijing[9].

Key words: ST-segment elevation myocardial infarction, Reperfusion treatment, Percutaneous coronary intervention

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