Acute myocardial infarction is a disease caused by sudden occlusion of the coronary arteries resulting in myocardial ischemia and
The mortality and morbidity rates are high.
The most direct and effective treatment to reduce mortality and morbidity is early recannalization of the occluded coronary artery and reperfusion of the ischemic myocardium.
Thrombolytic therapy used to be the treatment of choice for this disease and was documented to be effective in reperfusion. However, in recent years, primary percutaneous transluminal coronary angioplasty has been shown to have better results in reducing mortality, stroke (especially hemorrhagic stroke), reinfarction, recurrent ischemia, hospital stay and total costs in comparison with thrombolytic therapy.
Routine stenting is recommended in all cases to lower rates of target vessel revasculization, restenosis and even death. Furthermore, for patients with acute ST elevation myocardial infarction presenting to hospitals without available catheterization laboratories or experienced staff, transfer to a primary angioplasty center has been shown to be superior to on-site thrombolytic therapy, especially for patients presenting more than 3 hours after symptom onset.
(Tzu Chi Med J 2006; 18:1-7)