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Titolo:
ACUTE MYOCARDIAL-INFARCTION - THEN AND NOW
Autore:
SIMMONS J; WILLENS HJ; KESSLER KM;
Indirizzi:
UNIV MIAMI,SCH MED,DEPT MED,DIV CARDIOL MIAMI FL 33152 DEPT VET AFFAIRS MED CTR,MED SERV,CARDIOL SECT MIAMI FL 00000 MEM HOSP HOLLYWOOD FL 00000
Titolo Testata:
Chest
fascicolo: 6, volume: 107, anno: 1995,
pagine: 1732 - 1743
SICI:
0012-3692(1995)107:6<1732:AM-TAN>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE PLASMINOGEN-ACTIVATOR; RANDOMIZED CONTROLLED TRIAL; LOW-DOSE ASPIRIN; THROMBOLYTIC THERAPY; INTRAVENOUS STREPTOKINASE; SECONDARY PREVENTION; HOSPITAL DISCHARGE; PROGNOSTIC VALUE; DOUBLE-BLIND; IMMEDIATE ANGIOPLASTY;
Keywords:
ACUTE MYOCARDIAL INFARCTION; ANGIOPLASTY; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; ASPIRIN; BETA-ADRENERGIC BLOCKERS; HEPARIN; STRESS TESTING; THROMBOLYTIC AGENTS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
102
Recensione:
Indirizzi per estratti:
Citazione:
J. Simmons et al., "ACUTE MYOCARDIAL-INFARCTION - THEN AND NOW", Chest, 107(6), 1995, pp. 1732-1743

Abstract

Dramatic changes in the management of acute myocardial infarction (AMI) have occurred in the past decade. While previous management strategies were primarily supportive, current strategies focus on achieving and maintaining patency of the infarct-related artery restoring blood now to jeopardized myocytes, preserving left ventricular function, and preventing recurrences and complications in addition to promoting heating. Restoration of blood flow can be achieved pharmacologically with thrombolytic agents or mechanically with percutaneous transluminal coronary angioplasty (PTCA). Early use of antiplatelet agents and anticoagulants helps maintain patency of the infarct-related arteries and prevents thromboembolic complications. Administration of beta-blockers and angiotensin enzyme inhibitors are more specific means of conserving myocardium and preserving ventricular function. Additionally, several strategies for preventing arrhythmias such as prophylactic lidocaine use and routine long-term suppression of premature ventricular contractions with antiarrhythmic drugs are no longer routinely advocated. Basically, in the era prior to the eighth decade of this century, the primary direction of the therapeutic strategy for AMI was to reduce the oxygen demands in the infarcted myocardium; whereas in the subsequent years, the emphasis shifts to improvement in oxygen delivery via thrombolysis, PTCA, and coronary artery bypass graft surgery. These interventional changes, when added to greater sophistication in the use of drugs to reduce oxygen demands, resulted in significant lowering of myocardial mortality.

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Documento generato il 26/11/20 alle ore 10:17:19