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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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[Pharmacoinvasive Approach to the Treatment of Acute ST-Segment Elevation Myocardial Infarction. Current State of the

S G Milenkina1, A A Belogurov1, E P Delver1

  • 1Russian Medical Research Center of Cardiology.

Kardiologiia
|April 5, 2020
PubMed

Insights

For acute ST-segment elevation myocardial infarction, a pharmacoinvasive approach using thrombolytic therapy followed by transcutaneous coronary intervention is effective when primary PCI is delayed. This strategy ensures timely coronary perfusion recovery.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Pharmacology

Background:

  • Current guidelines recommend primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
  • Logistical and infrastructural challenges in some regions can delay timely PCI.
  • Alternative strategies are needed to ensure rapid coronary reperfusion in STEMI patients.

Purpose of the Study:

  • To evaluate the efficacy of a pharmacoinvasive approach for STEMI treatment.
  • To assess the role of thrombolytic therapy followed by PCI when primary PCI is not feasible.
  • To analyze the use of recombinant prourokinase in this treatment strategy.

Main Methods:

  • Review of major studies on the pharmacoinvasive strategy for STEMI.
  • Analysis of outcomes associated with thrombolytic therapy and subsequent PCI.
  • Focus on the use of a third-generation thrombolytic drug, recombinant prourokinase.

Main Results:

  • The pharmacoinvasive approach facilitates early coronary perfusion recovery in STEMI.
  • Thrombolytic therapy followed by PCI is a viable alternative when primary PCI is delayed.
  • Recombinant prourokinase demonstrated effectiveness in this therapeutic strategy.

Conclusions:

  • The pharmacoinvasive approach is a crucial treatment option for STEMI, especially in resource-limited settings.
  • Timely reperfusion can be achieved through thrombolysis and subsequent PCI.
  • Further research into thrombolytic agents like recombinant prourokinase is warranted for STEMI management.

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