Medicus, Vol. 12 No. 1_ Kardiologija, 2003.
Pregledni rad
Percutaneous Coronary Interventions in the Acute Coronary Syndrome
Šime Mihatov
Sažetak
The acute coronary syndromes (ACS) is one
of the most frequent reasons for hospitalization in the developed
western countries. The leading place takes the unstable
angina pectoris (UAP) and the acute myocardial infarction without
the ST-segment elevation in the ECG (NSTEMI). This trend
is constantly increasing and surpasses the number of patients
with myocardial infarction and the ST-segment elevation in the
ECG (STEMI). Despite the achieved improvements in treatment,
the unstable angina pectoris still has an unfavorable
prognosis with the possibility of aggravation and the occurrence
of an acute myocardial infarction (AMI). Large clinical
trials of the optimal treatment assessment, UAP and NSTEMI,
show the advantage of early intervention treatment, which
goes on after the six-month or one-year follow-up. The results
are even better after the administration of the glycoprotein II
b/IIIa receptor inhibitors (GP IIb/IIIa). The greatest benefits
from the early intervention treatment have patients with a high
risk for progression and onset of myocardial infarction or death.
Today, the optimal treatment of the high-risk patients with
unstable coronary disease comprises invasive approach and
early application of percutaneous coronary intervention (PCI),
with previous ant-ischemic and anti-thrombotic therapy. In
patients with AMI the re-establishing of anterograde flow within
a few hours after the occurrence of AMI increases survival
and saves the jeopardized myocardium. Thus, the reperfusion
treatment is the milestone in the treatment of AMI. It encompasses
thrombolytic treatment and administration of primary
percutaneous coronary intervention (pPCI). The primary
PCI is nowadays the therapy of choice in the treatment of AMI.
Ključne riječi
percutaneous coronary intervention; primary angioplasty; acute coronary syndromes; unstable angina pectoris; acute myocardial infarction
Hrčak ID:
20516
URI
Datum izdavanja:
27.1.2003.
Posjeta: 5.976 *