MINI-SYMPOSIUM
Recent advances in primary percutaneous intervention for acute myocardial infarction
London Chest Hospital, London, UK
Correspondence to:
Correspondence to:
Professor Martin T Rothman
Cardiac Research Office, London Chest Hospital, Bonner Road, London E2 9JX, UK; martin.rothman@bartsandthelondon.nhs.uk
Abbreviations: AMI, acute myocardial infarction; BMS, bare metal stents; BMSC, bone marrow stem cell; DES, drug eluting stent; EMERALD, enhanced myocardial efficacy and recovery by aspiration of liberalized debris; EPC, endothelial progenitor cell; GpRA, glycoprotein IIb/IIIa receptor antagonist; ISR, in-stent restenosis; IVUS, intravascular ultrasound; LV, left ventricular; NFMI, non-fatal myocardial infarction; PPCI, primary percutaneous coronary intervention; SES, sirolimus eluting stent; STEMI, ST elevation myocardial infarction; TIMI, thrombolysis in myocardial infarction
Keywords: acute myocardial infarction; percutaneous coronary intervention; ST elevation myocardial infarction; STEMI
| The first 150 words of the full text of this article appear below. |
Interventional cardiology has evolved since the first studies comparing primary percutaneous intervention (PPCI) and intravenous thrombolysis for the treatment of ST segment elevation myocardial infarction (STEMI). Indeed it may now seem remarkable that in an era where abrupt vessel closure and restenosis occurred routinely in up to 8% and 40%, respectively,1,2 plain balloon angioplasty was able to demonstrate significant improvements in short and long term outcome relative to thrombolysis.3,4 This emphasises the prognostic importance of restoring effective flow in the culprit vessel as early as possible, for which PPCI has been highly effective from the outset. However, the corollary is that despite major advances in stent technology and adjuvant pharmacology since that time, the absolute outcome benefits of PPCI remain definite but modest.5 Here we put into context some of the recent advances in the field of PPCI, highlighting key questions that are yet to be answered, and speculate on
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