Treatment and Care of Patients with ST-Segment Elevation Myocardial Infarction-What Challenges Remain after Three Decades of Primary Percutaneous Coronary Intervention?
Vittorio ZuccarelliStefano AndreaggiJason L WalshRafail A KotroniasMiao ChuJonathan VibhishananAdrian Paul BanningGiovanni Luigi De MariaPublished in: Journal of clinical medicine (2024)
Primary percutaneous coronary intervention (pPCI) has revolutionized the prognosis of ST-segment elevation myocardial infarction (STEMI) and is the gold standard treatment. As a result of its success, the number of pPCI centres has expanded worldwide. Despite decades of advancements, clinical outcomes in STEMI patients have plateaued. Out-of-hospital cardiac arrest and cardiogenic shock remain a major cause of high in-hospital mortality, whilst the growing burden of heart failure in long-term STEMI survivors presents a growing problem. Many elements aiming to optimize STEMI treatment are still subject to debate or lack sufficient evidence. This review provides an overview of the most contentious current issues in pPCI in STEMI patients, with an emphasis on unresolved questions and persistent challenges.
Keyphrases
- st segment elevation myocardial infarction
- percutaneous coronary intervention
- st elevation myocardial infarction
- acute myocardial infarction
- acute coronary syndrome
- antiplatelet therapy
- coronary artery disease
- coronary artery bypass grafting
- heart failure
- atrial fibrillation
- coronary artery bypass
- ejection fraction
- newly diagnosed
- risk factors
- young adults
- smoking cessation
- palliative care
- patient reported outcomes
- pain management
- health insurance