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- ACT, activated clotting time
- AMI, acute myocardial infarction
- IABP, intra-aortic balloon pump
- PCI, percutaneous coronary intervention
- UFH, unfractionated heparin
Since primary percutaneous coronary intervention (PCI) is the mainstay of reperfusion in acute myocardial infarction (AMI), and because AMI represents the most urgent situation for PCI, recommendations based on scientific evidence and expert experience would be useful for centres practising primary PCI or those looking to set up a primary PCI programme. With this in mind, a group of eight European interventional cardiologists (all based at high volume centres) formed an expert consensus to provide recommendations on this subject.
The recommendations are intended for specialists who possess the necessary knowledge, experience, and skills to perform PCI, and who work in environments with appropriate resources and facilities.
RECOMMENDATIONS FOR PCI IN AMI
When performed by experienced operators, we strongly recommend PCI as the reperfusion strategy of choice for patients with AMI. When thrombolysis is contraindicated or has failed, or when patients are in cardiogenic shock, rapid transfer to a secondary unit should be ensured. Studies have shown that, where facilities are available, most AMI patients are candidates for PCI,1 and that PCI is effective in re-establishing coronary artery perfusion and in providing a good outcome in both the short and long term.2
We strongly recommend that PCI for AMI is performed swiftly, with a door-to-balloon …