[Interventional therapy of acute myocardial infarction]

Area of Science:

• Cardiology
• Internal Medicine

Context:

• Current guidelines differentiate acute myocardial infarction (AMI) into ST-elevation AMI (STEMI) and non-ST-elevation AMI (NSTEMI).
• Clinical practice increasingly relies on the acute coronary syndromes (ACS) classification for treatment strategies.
• This classification distinguishes between ACS with ST-elevation (STE-ACS, equivalent to STEMI) and ACS without ST-elevation (NSTE-ACS).

Purpose:

• To outline the clinical relevance of ACS classification in guiding invasive strategies.
• To differentiate treatment approaches based on risk stratification within NSTE-ACS.
• To emphasize the importance of timely reperfusion therapy in STE-ACS.

Summary:

• NSTE-ACS is further categorized into high-risk and low-risk groups, dictating early invasive versus conservative management, respectively.
• For STE-ACS, primary angioplasty is the preferred reperfusion therapy, contingent on timely "door-to-balloon" times.
• Establishing local networks is crucial for achieving optimal outcomes in Germany, where timely angioplasty is widely feasible.

Impact:

• Facilitates evidence-based decision-making in acute coronary syndromes management.
• Promotes the optimization of reperfusion strategies for STEMI patients.
• Highlights the importance of inter-hospital collaboration and network development for improving patient care and outcomes.