Current Status and Future Direction of Antithrombotic Therapy for Patients with STEMI Undergoing Primary PCI
Vogel, Rosanne F. (University of Amsterdam)
Delewi, Ronak (University of Amsterdam)
Badimon, Lina (Institut d'Investigació Biomèdica Sant Pau)
Angiolillo, Dominick J (University of Florida)
Vlachojannis, J. (Utrecht University)

Fecha:	2022
Resumen:	Since the introduction of the first pharmacological therapy for the treatment of patients with acute myocardial infarction in the early 20th century, treatment of myocardial infarction has evolved extensively throughout the years. Mechanical revascularization therapies such as the percutaneous transluminal coronary angioplasty, combined with the ongoing development of pharmacological therapies have successfully improved the survival of patients with acute myocardial infarction. To date, antiplatelet therapy (consisting of aspirin and an oral P2Y inhibitor) and anticoagulation therapy represent the main stay of pharmacological treatment in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). The routine use of clopidogrel as antiplatelet agent has been largely replaced by the use of the more potent P2Y inhibitors ticagrelor and prasugrel. Unfractionated heparin remains the preferred anticoagulant therapy, despite the development of other anticoagulants, including enoxaparin and bivalirudin. To date, limited evidence exists supporting a pre-hospital initiation of antiplatelet and anticoagulant therapy in STEMI patients. The use of potent intravenous antiplatelet agents, including the glycoprotein IIb/IIIa inhibitors and the intravenous P2Y inhibitor cangrelor, is currently restricted to specific clinical settings. While several potent antithrombotic agents already exist, the search for novel potent antithrombotic agents continues, with a focus on balancing antithrombotic properties with an improved safety profile to reduce excess bleeding. This review provides an overview of currently available pharmacological therapies for the treatment of STEMI patients undergoing primary PCI, and an outlook for the ongoing development of novel agents in this field.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Ressenya ; recerca ; Versió publicada
Materia:	Anticoagulation ; Antiplatelet therapy ; Antithrombotic therapy ; Primary percutaneous coronary intervention ; STEMI ; ST-segment elevation myocardial infarction
Publicado en:	Reviews in Cardiovascular Medicine, Vol. 23 Núm. 9 (september 2022) , ISSN 2153-8174

DOI: 10.31083/j.rcm2309297

22 p, 7.1 MB

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