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What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?

What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?
What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention?
Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key components of STEMI include formation of occlusive thrombus, mediation and ultimately amplification of the local vascular inflammatory response resulting in increased vasoreactivity, oedema formation, and microvascular obstruction. Activation, degranulation, and aggregation of platelets are the platforms from which these components develop. Therefore, prompt, potent, and predictable antithrombotic therapy is needed to optimise clinical outcomes after primary percutaneous coronary intervention. We review present pharmacological and mechanical adjunctive therapies for reperfusion and ask what is the optimum combination when primary percutaneous coronary intervention is used as the mode of revascularisation in patients with STEMI.
0140-6736
633-644
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Gurbel, P.A.
c9eb3027-1c8a-4c18-a134-23c0e6567665
Myat, A.
bc32a212-e9e2-49e4-bfb5-ac960a6cbf6c
Bhatt, D.L.
3b15d58d-b3c3-4eab-a1e6-86ff09d7f6c7
Redwood, S.R.
0834d0fe-4f40-4700-b28c-4a67c48b4404
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Gurbel, P.A.
c9eb3027-1c8a-4c18-a134-23c0e6567665
Myat, A.
bc32a212-e9e2-49e4-bfb5-ac960a6cbf6c
Bhatt, D.L.
3b15d58d-b3c3-4eab-a1e6-86ff09d7f6c7
Redwood, S.R.
0834d0fe-4f40-4700-b28c-4a67c48b4404

Curzen, N., Gurbel, P.A., Myat, A., Bhatt, D.L. and Redwood, S.R. (2013) What is the optimum adjunctive reperfusion strategy for primary percutaneous coronary intervention? Lancet, 382 (9892), 633-644. (doi:10.1016/S0140-6736(13)61453-1). (PMID:23953387)

Record type: Article

Abstract

Acute ST-segment elevation myocardial infarction (STEMI) is a dynamic, thrombus-driven event. As understanding of its pathophysiology has improved, the central role of platelets in initiation and orchestration of this process has become clear. Key components of STEMI include formation of occlusive thrombus, mediation and ultimately amplification of the local vascular inflammatory response resulting in increased vasoreactivity, oedema formation, and microvascular obstruction. Activation, degranulation, and aggregation of platelets are the platforms from which these components develop. Therefore, prompt, potent, and predictable antithrombotic therapy is needed to optimise clinical outcomes after primary percutaneous coronary intervention. We review present pharmacological and mechanical adjunctive therapies for reperfusion and ask what is the optimum combination when primary percutaneous coronary intervention is used as the mode of revascularisation in patients with STEMI.

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Published date: 17 August 2013
Organisations: Human Development & Health

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Local EPrints ID: 355680
URI: http://eprints.soton.ac.uk/id/eprint/355680
ISSN: 0140-6736
PURE UUID: d455bdc1-2565-4208-baed-107e7c25b9a6
ORCID for N. Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 03 Sep 2013 14:32
Last modified: 10 Jan 2022 02:50

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Contributors

Author: N. Curzen ORCID iD
Author: P.A. Gurbel
Author: A. Myat
Author: D.L. Bhatt
Author: S.R. Redwood

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