Acute myocardial ischemia and infarction: Making the right decisions in antithrombotic and reperfusion therapies

R. C. Hendel

Research output: Contribution to journalReview article

Abstract

Acute coronary syndromes, which include unstable angina and myocardial infarction (MI), have the common pathophysiological mechanism of intracoronary thrombus formation. Treatment of an acute MI initially focuses on reperfusion with thrombolysis or percutaneous coronary interventions (PCI)s. Primary or direct percutaneous interventions, with traditional angioplasty and stenting, appear to provide superior efficacy for acute MI, although temporal factors are crucial. However, antiplatelet and antithrombin therapies are also vital for the maintenance and enhancement of complete coronary perfusion and for primary management of non-Q wave myocardial infarction (NQWMI) and unstable angina. Recent advances in the pharmacological treatment include the use of direct thrombin inhibitors, low-molecular-weight heparin, and glycoprotein IIb/IIIa antagonists, all of which have shown substantial benefit for acute coronary syndromes. The article focuses on the clinical literature supporting the utility of recent therapeutic advances and outlines the current indications for such treatments.

Original languageEnglish (US)
Pages (from-to)75-88
Number of pages14
JournalSeminars in Respiratory and Critical Care Medicine
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Anticoagulant
  • Antiplatelet
  • Coronary artery disease
  • Ischemia
  • Myocardial infarction
  • Thrombolysis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine
  • Critical Care

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