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Internal and Emergency Medicine

, Volume 3, Issue 2, pp 83–84 | Cite as

STEMI management: trials, registries, and the real world

  • Giovanni MelandriEmail author
  • Franco Semprini
  • Samuele Nanni
  • Daniela Calabrese
  • Fabio Vagnarelli
  • Angelo Branzi
IM - Commentary

Primary angioplasty (P-PCI) is the preferred treatment of patients with ST-segment elevation myocardial infarction (STEMI) in both American and European guidelines. The reason for this preference is the evidence that the mechanical approach improves coronary patency, TIMI-flow rates and ultimately the overall survival.

Nevertheless, P-PCI has its own drawbacks: it needs skill and must be delivered in a timely fashion (two contrasting requirements, in that skill is linked to activity volume which, in turn, decreases along with catheterization laboratories proliferation); not to mention the costs.

So far, in no single study has P-PCI been shown to reduce mortality, a goal whose achievement has been suggested only in an overview of small trials. Moreover, the advantage fades when P-PCI is compared with contemporary lytic regimens [1].

Therefore, it may be asked whether this apparent small advantage of P-PCI may be generalized to the real world. Indeed, it has been recognized for a long...

References

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Copyright information

© SIMI 2008

Authors and Affiliations

  • Giovanni Melandri
    • 1
    Email author
  • Franco Semprini
    • 1
  • Samuele Nanni
    • 1
  • Daniela Calabrese
    • 1
  • Fabio Vagnarelli
    • 1
  • Angelo Branzi
    • 1
  1. 1.Dipartimento Cardio-Toraco-VascolareIstituto di CardiologiaBolognaItaly

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