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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Year 2008 ESC ST-segment elevation myocardial infarction guidelines: implications for the interventional cardiologist—from evidence to recommendations and practice

Frans Van de Werf

Department of Cardiology, University Hospitals Leuven, Leuven, Belgium

Key Words: ST-elevation acute myocardial infarction • Guidelines

The first 150 words of the full text of this article appear below.


   Introduction
 
The management of acute myocardial infarction (MI) continues to evolve, and good clinical practice should be based on reliable evidence resulting from well-conducted clinical trials. Prompted by a substantial number of new, important published studies, the European Society of Cardiology has recently published the 2008 updated guidelines for the management of acute myocardial infarction in patients presenting with persistent ST-segment elevation (STEMI).1 Although the goals of the 2003 and 2008 guidelines1,2 remain the same and include early diagnosis, reperfusion therapy as soon as possible, and optimal secondary prevention, the methods used to achieve them have been modified based on new information from recently published clinical trial data.

When compared with the 2003 guidelines, the new guidelines include significantly more emphasis on early pre-hospital diagnosis, effective triage, and the establishment of transfer networks. Important changes made relate to antithrombotic therapies and the choice between mechanical vs. pharmacological reperfusion. Importantly, the recommendations . . . [Full Text of this Article]


   Logistics of care: early pre-hospital diagnosis/triage and networks
 

   Reperfusion therapy
 

   Primary percutaneous coronary intervention vs. fibrinolytic therapy: selection criteria
 

   Primary percutaneous coronary intervention: adjunctive therapies
 
Antiplatelet co-therapy
Antithrombin co-therapy
Adjunctive devices

   Fibrinolytic therapy: adjunctive therapies
 

   Antithrombotic treatment without reperfusion therapy
 

   Angiography after fibrinolytic therapy
 

   Long-term management
 

   Summary
 

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