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Updated: Aug 23, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
[Acute myocardial infarct with ST segment elevation--thrombolytic therapy]
1Klinicka bolnica Merkur Zajceva 19 10000 Zagreb, Hrvatska.
Insights
Treatment for ST-elevation myocardial infarction (STEMI) involves restoring coronary blood flow. Thrombolysis is common, but percutaneous coronary interventions (PCI) offer better outcomes for select patients despite higher costs and complexity.
Area of Science:
- Cardiology
- Interventional Cardiology
- Emergency Medicine
Context:
- Acute myocardial infarction with ST-segment elevation (STEMI) requires prompt restoration of coronary blood flow.
- Current treatment strategies include thrombolytic agents, percutaneous coronary interventions (PCI), and urgent coronary surgery.
- Thrombolysis is widely used due to its accessibility and efficacy in many hospitals.
Purpose:
- To compare the effectiveness and limitations of thrombolysis versus PCI in managing STEMI patients.
- To highlight the factors influencing the choice between reperfusion strategies for STEMI.
Summary:
- Thrombolysis is favored for its ease of use and widespread availability.
- Percutaneous coronary interventions (PCI) are preferred for achieving TIMI grade 3 flow and potentially reducing early mortality in specific STEMI patient groups.
- Challenges for PCI include high costs, specialized equipment, limited centers of expertise, and the chronic nature of atherosclerosis.
Impact:
- Understanding these treatment trade-offs is crucial for optimizing STEMI patient care.
- This comparison informs clinical decision-making regarding reperfusion therapy for acute myocardial infarction.
- Highlights the ongoing need for accessible and effective treatments for ischemic heart disease.
Abstract:
The treatment of patients with acute myocardial infarction who present with the elevation of ST segment on electrocardiogram (STEAMI) is based on the need of re-establishing coronary blood flow through the occluded epicardial artery. This goal could be achieved using thrombolytic agents, or "mechanically" with percutaneous coronary interventions (PCI) or by urgent coronary surgery. A large number of STEAMI patients treated with thrombolysis, simple use of these drugs in almost all hospitals, and their efficacy are the main reasons for their use. A smaller number of patients in whom TIMI grade 3 flow could be achieved and higher early mortality of these patients are the reasons in favor of percutaneous coronary interventions. Early reocclusion rates, expensive equipment, small number of medical centers with skillful team for safe procedures, and the nature of these "mechanical" interventions for atherosclerosis which is a biologic phenomenon, speak against these procedures.
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