ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Primary Angioplasty For Acute Myocardial Infarction
Dr. Hüseyin YILMAZa
aKardiyoloji AD, Akdeniz Üniversitesi Tıp Fakültesi, ANTALYA
The treatment of ST-segment elevation myocardial infarction in 1950-1960 was consisted of only bedrest, upto the 1970s debate raged as to whether coronary thrombosis was the cause or the consequence of ST-segment elevation myocardial infarction (STEMI). In 80’s discussion focused on how long to keep patients in bed (hospital). The probable role of coronary care units in reducing mortality was discussed and “warning arrhythmias” were treated strictly to lower the cardiac mortality and morbidity and several studies undergone to get an answer. As recently as the early 1980s, no treatment had been shown to reduce mortality or morbidity in the acute phase of STEMI. Fibrinolytic therapy was used in many European centres and then was discarded as being ineffective, and even dangerous, on the basis of results from inadequately powered trials. In 1980, DeWood and colleagues reported that about 80% of patients with acute MI had coronary occlusion, measured using coronary arteriography, and that the occlusion was due to an intraluminal thrombus.
Later studies showed that the coronary thrombus could be dissolved with intracoronary (and later intravenous) administration of streptokinase, and a meta-analysis demonstrated a reduction in mortality.
Then, in 1986the results from a small, randomized trials suggested that percutaneous coronary intervention was superior to intracoronary streptokinase therapy in the management of AMİ, and the advantage of Primary angioplasty over trombolitic therapy in patients with STEMI has been shown in a variety of clinical situations with the aid of developing technologies and studies. Nowadays, Primary angioplasty is the first choice of the treatment modality in patients with STEMI.Keywords: Coronary artery disease, acute myocardial infarction, percutanous transluminal angioplasty, intracoronary stentTurkiye Klinikleri J Int Med Sci 2006, 2(42):14-19
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