Cardiology
Review
Aggressive Interventional Treatment of Acute Myocardial InfarctionLessons from the Animal Laboratory Applied to the Catheterization Suite Division of Cardiology, University of Texas Health Science Center, Houston, Tex., USA
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Article / Publication Details
Received: October 24, 1994
Accepted: December 07, 1994
Published online: November 19, 2008
Issue release date: 1995
Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 0
ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)
For additional information: https://www.karger.com/CRD
Abstract
Myocardial necrosis progresses with the duration of coronary occlusion in the early stages of acute myocardial infarction. Prompt recanalization of the infarct-related artery resulting in effective and sustained reperfusion of jeopardized myocardium is the goal of modern therapy. Clinical thrombolysis trials have demonstrated a significant survival advantage for treated patients, but only a modest recovery of global or regional systolic left ventricular function. Accelerated regimens of administering currently available thrombolytic agents are associated with early coronary patency rates approaching 85%, although effective coronary perfusion is restored in only slightly better than one half of patients treated. Primary angioplasty without antecedent thrombolytic therapy has resulted in high patency rates with superior coronary flow when performed in some experienced centers. Treatment of cardiogenic shock requires immediate mechanical or surgical intervention to reestablish coronary perfusion often following placement of a circulatory assistance device. Future trends toward very early initiation of thrombolytic therapy, improvements in adjunctive therapy and advances in the noninvasive detection of recanalization should permit selective use of aggressive interventional therapy for failed thrombolysis in a minority of patients with acute myocardial infarction.
© 1995 S. Karger AG, Basel
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Article / Publication Details
Received: October 24, 1994
Accepted: December 07, 1994
Published online: November 19, 2008
Issue release date: 1995
Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 0
ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)
For additional information: https://www.karger.com/CRD
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