Latest STEMI treatment: a focus on current and upcoming devices
Elisabetta Moscarella1, Salvatore Brugaletta1, Manel Sabaté1
1a Hospital Clínic, Cardiovascular Clinic Institute , Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain.
Expert Review of Medical Devices
|October 23, 2018
Summary
Optimizing primary percutaneous coronary intervention (pPCI) with drug-eluting stents and complete revascularization is key for ST-elevation myocardial infarction (STEMI) patients. Mechanical circulatory support (MCS) in STEMI with cardiogenic shock (CS) has not yet improved mortality.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- Ischemic heart disease is a leading global cause of death.
- ST-elevation myocardial infarction (STEMI) requires prompt intervention for optimal outcomes.
- Cardiogenic shock (CS) complicates STEMI, necessitating advanced therapeutic strategies.
Purpose of the Study:
- To review optimization strategies for primary percutaneous coronary intervention (pPCI) in STEMI.
- To evaluate the efficacy of mechanical circulatory support (MCS) devices in STEMI patients with CS.
Main Methods:
- Review of current literature on pPCI optimization techniques.
- Analysis of recent data regarding the use of intra-aortic balloon pump (IABP), Impella, TandemHeart, and VA-ECMO in STEMI with CS.
Main Results:
- Second-generation drug-eluting stent implantation and complete revascularization are recommended in pPCI.
- Thrombectomy does not improve mortality in STEMI patients.
- Current MCS devices have not demonstrated improved mortality in STEMI patients with CS.
Conclusions:
- pPCI optimization focuses on stent selection and complete revascularization for improved outcomes.
- The role and benefit of MCS in STEMI complicated by CS require further investigation, as current devices show no mortality benefit.
Keywords:
Bare metal stentImpellaST elevation myocardial infarctionTandemheartdrug eluting stentextracorporeal membrane oxygenationintra aortic balloon pumppercutaneous coronary interventionthrombus aspirationvenous–arterial extracorporeal membrane oxygenationMore Related Videos
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