Primary angioplasty has proven to be the best therapeutic option for acute myocardial infarction AMI , providing early, optimal reestablishment of coronary flow and resulting in a significant reduction in mortality as compared to thrombolytic treatment. In an earlier study we reported that satisfactory myocardial reperfusion, as assessed by noninvasive markers, such as resolution of ST-segment elevation, early T-wave inversion, and time to peak enzyme levels, is associated with a significantly lower risk for heart failure and in-hospital or mid-term mortality in patients with myocardial infarction treated with thrombolysis and primary angioplasty. In this study we prospectively compared the prognostic value of noninvasive indicators of coronary perfusion with TIMI grade 3 flow for the appearance of complications at short- and mid-term in patients with AMI treated by primary angioplasty. Patients with complete bundle branch block or cardiogenic shock were excluded. At emergency room admission, all patients received mg of aspirin and were intravenously treated with heparin to reach an activated coagulation time of approximately s during angioplasty. In patients receiving an intracoronary stent, clopidogrel, or ticlopidine was continued for 4 weeks.
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An electrocardiographic sign of coronary artery obstruction. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. Placa fisuring the cause of acute myocardial infarction, sudden ischaemic death and crescendo angina.
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Valor del diagnóstico clínico precoz a través del electrocardiograma
An electrocardiographic sign of coronary artery obstruction. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. Placa fisuring the cause of acute myocardial infarction, sudden ischaemic death and crescendo angina. Selective intracoronary thrombolysis in acute myocardial infarction and unstable angina pectoris.
ILCOR: manejo inicial del Síndrome Coronario Agudo: Revisión y cambios