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Chapter-10 Percutaneous Coronary Intervention in Acute Myocardial Infarction

BOOK TITLE: The Protocol Book for Intensive Care

Author
1. Ray Shuvanan
2. Mitra Sabyasachi
ISBN
9789352703050
DOI
10.5005/jp/books/14144_11
Edition
5/e
Publishing Year
2018
Pages
19
Author Affiliations
1. AMRI Hospital (Salt Lake), Kolkata, India, Fortis Hospital, Anandapur, Kolkata, India, Fortis Hospital, Kolkata, West Bengal, India, Fortis Hospitals, Kolkata, West bengal, India, Fortis Hospitals, Anandapur, Kolkata, West Bengal, India
2. Fortis Hospital, Kolkata, West Bengal, India, Fortis Hospitals, Kolkata, West bengal, India
Chapter keywords
Primary percutaneous coronary intervention, PPCI, percutaneous coronary intervention, PCI, STEMI, preprocedural protocol, adjunctive pharmacology, reperfusion injury

Abstract

Primary percutaneous coronary intervention (PPCI) involves opening of a thrombus laden large epicardial artery in a patient with unstable hemodynamics in a time-dependent manner to establish undeterred flow through the microcirculation. It requires a cognitive knowledge base and a technical skill that is somewhat different from that required to perform elective percutaneous coronary intervention (PCI). A report from the National Registry of Myocardial Infarction (NRMI) data, which included a cohort of 29,222 patients with ST-elevation myocardial infarction (STEMI) treated with PCI within 6 hours of presentation. Based upon the randomized clinical trials, PPCI is preferred when performed in a timely fashion by an expert operator in patients with STEMI, or an MI with a new or presumably new LBBB or a true posterior MI. A detailed discussion on protocol for PPCI has been given in this chapter. Seven flowcharts are also presented in this chapter, which are helpful for quick reading.

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