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Percutaneous Mechanical Reperfusion During Acute Myocardial Infarction

Department of Medicine/Division of Cardiology, University of Texas Health Science Center at San Antonio, San Antonio, TX

Joe M. Moody, Jr, MD

Department of Medicine/Division of Cardiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, moodyjm{at}uthscsa.edu

Steven R. Bailey, MD

Department of Medicine/Division of Cardiology, University of Texas Health Science Center at San Antonio, San Antonio, TX

The treatment of acute myocardial infarction has progressed from bedrest to mechanical, catheter-based reperfusion. The authors review the use of percutaneous coronary intervention (PCI) as a primary treatment for acute myocardial infarction and the use of adjunctive agents. The most recent American College of Cardiology/ American Heart Association (ACC/AHA) guidelines for the use of PCI in ST segment elevation myocardial infarction (MI) advocate the use of PCI as primary therapy at those centers in which the procedure can be performed within accepted standards. Because a majority of hospitals (80%) do not have the capability of performing primary PCI, most patients are treated with thrombolytic therapy. PCI should be considered in those patients treated with thrombolytic therapy who have persistent or recurrent ischemia and/or cardiogenic shock. For patients with non-ST elevation MI, the use of an invasive strategy (early angiography and PCI if needed) has recently shown to be beneficial. Although revascularization is the basis of the acute therapy of MI, additional pharmacologic therapy in the acute setting is now recognized as a key to favorable long-term outcome.

Key Words: myocardial infarction • percutaneous coronary interventions • stents

Journal of Intensive Care Medicine, Vol. 17, No. 4, 162-173 (2002)
DOI: 10.1177/0885066602017004002


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