[Mechanical reperfusion in acute myocardial infarction]

Nowadays, it has been demonstrated that reperfusion therapy in acute myocardial infarction diminishes mortality and improves ventricular function. Primary percutaneous transluminal coronary angioplasty (ACTPp) was described in 1983 by Hartzler as an alternative treatment in acute myocardial infarction. The results of this procedure were considered excellent. In 1996 the committee built up by the ACC/AHA published in the 1999 updated JACC's issue, a statement of the position that occupied at that moment primary angioplasty in the treatment of acute myocardial infarction. This committee pointed that this therapy showed to be an excellent alternative compared with the use of thrombolytic agents in acute myocardial infarction with ST elevation, patients who presented < 12 hs of the onset of symptoms according to the following conditions: 1. In less time, 2. Supported by trained staff, and 3. In an experience cath lab. This communication was introduced prior to the use of interventionist therapy with stents with or without the utilization of glycoproteins inhibitors. The analysis of results of different comparative studies of ACTPp with or without stents vs the use with or without II/IIIa glycoproteins inhibitors, was also included in this communication; among them it stands out the epistent which demonstrated less events as far as 6 months and was statistical significant in patients treated with Stent and abciximad. In conclusion we believe that ACTPp with Stent and glycoprotein inhibitors offers better results than those obtained from a combined therapy with thrombolytic agents and IIb/IIIa, however, we must recognise that there are limitations when performing angioplasty, as there is a lack of an efficient 24 hr. cath lab.