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Reperfusion Strategies in Acute Myocardial Infarction: State of the Art
Rangel, Fernando Oswaldo Dias.
  • Rangel, Fernando Oswaldo Dias; Hospital Pró-Cardíaco. Rio de Janeiro. BR
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
Subject(s)


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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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