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Chapter-056 Primary Angioplasty in 2014

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Chandra Praveen
2. Chouhan Nagendra S
ISBN
9789351526186
DOI
10.5005/jp/books/12415_57
Edition
1/e
Publishing Year
2015
Pages
9
Author Affiliations
1. Medanta—The Medicity, Gurgaon, Haryana, India, Division of Interventional Cardiology and Structural Heart, New Delhi, India, Medanta—The Medicity, Gurugram, Haryana, India; Medanta Moolchand Heart Institute, New Delhi, India, Medanta Heart Institute, Medanta—The Medicity, Gurugram, Haryana, India, National Interventional Council (NIC), Cardiological Society of India; Medanta–The Medicity, Gurugram, Haryana, India, Heart Institute, Medanta Super Speciality Hospital, Gurugram, Haryana, India, Medanta—The Medicity, Gurugram, Haryana, India, Medanta Moolchand Heart Institute, Delhi, India, Medanta: The Medicity, Gurgaon, Haryana, India; NIC-2014–15, Medanta—The Medicity, Gurugram, Haryana, India, Medanta–The Medicity, Gurugram, Haryana, India, Medanta Heart Institute, Medanta—The Medicity, Gurgaon, Haryana, India, Medanta—The Medicity, Haryana, India, Cardiological Society of India; Medanta–The Medicity, Gurgaon, Haryana, India, Medanta Medicity, Gurgaon, Haryana, India
2. Medanta Heart Institute, Medanta—The Medicity, Haryana, India, Medanta Heart institute, Medanta—The Medicity, Gurgaon, Haryana, India, Medanta—The Medicity, Gurugram, Haryana, India
Chapter keywords
Thrombotic occlusion, epicardial coronary artery, acute ST elevation myocardial infarction, coronary flow, chemical reperfusion, mechanical reperfusion, primary percutaneous coronary angioplasty, thrombolysis

Abstract

Thrombotic occlusion of major epicardial coronary artery in the absence of adequate collaterals is the culprit for acute ST elevation myocardial infarction (STEMI). Restoration of normal coronary flow can be achieved either by mechanical or chemical reperfusion. Primary percutaneous coronary angioplasty (PCI) was compared with thrombolysis in a clinical trial, and from this trial it showed that primary PCI is superior in reducing short-term mortality irrespective of delay between symptom onset and hospital presentation. But thrombolysis if started early within first 2 hours (prehospital thrombolysis) appears to be even more efficacious in comparison to primary PCI. In this chapter status of PCI in India, pharmacoinvasive approach to PCI and newer drugs and devices in AMI armamentarium are also discussed. The prognosis for patients developing STEMI can be markedly improved with timely reperfusion therapy.

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