Reperfusion Strategies in Acute Myocardial Infarction: State of the Art
Int. j. cardiovasc. sci. (Impr.)
;
35(1): 113-122, Jan.-Feb. 2022. graf
Article
in English
| LILACS
| ID: biblio-1356305
ABSTRACT
Abstract ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA ( Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies - intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), anti-inflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre- and post-conditioning and stem cell therapy - have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results:
These therapies need confirmation in larger studies to be implemented in clinical practice
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Prognosis
/
Myocardial Reperfusion
/
Reperfusion Injury
/
ST Elevation Myocardial Infarction
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Practice guideline
/
Prognostic study
/
Systematic reviews
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2022
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital Pró-Cardíaco/BR
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