STEMI Guidelines Emphasize Timely Reperfusion, Ideally PCI

Guidelines suggest patients call emergency medical services for transport to hospital

MONDAY, Dec. 17 (HealthDay News) -- New guidelines urge timely management for patients with ST-segment elevation myocardial infarction (STEMI), according to a scientific report co-published online Dec. 17 in Circulation and the Journal of the American College of Cardiology.

Patrick T. O'Gara, M.D., from Harvard Medical School in Boston, and colleagues from the American College of Cardiology Foundation and the American Heart Association reviewed and analyzed data to produce practice guidelines for STEMI management.

Noting that patients with STEMI typically do not seek medical care for about 1.5 to two hours after symptom onset, the authors encourage health care providers to assist patients when possible to make anticipatory plans for timely recognition and response to STEMI, including learning warning symptoms, creating a survival plan, and discussing risk reduction. Patients should be encouraged to call 9-1-1 and be transported to the hospital by the emergency medical services (EMS). In addition, communities should create and maintain a regional system of STEMI care. At the site of first medical contact (FMC), a 12-lead electrocardiogram should be performed by EMS personnel. Reperfusion therapy, ideally primary percutaneous coronary intervention (PCI), should be administered to all eligible patients with STEMI within 12 hours of symptom onset. Patients who arrive at a non-PCI-capable hospital should be transferred to a PCI-capable hospital. In the absence of contraindications, fibrinolytic therapy should be administered when the anticipated FMC-to-device time is anticipated to exceed 120 minutes, and, when indicated, should be administered within 30 minutes of arrival at the hospital.

"We're looking to a future where more patients survive with less heart damage and function well for years thereafter," O'Gara said in a statement. "We hope the guidelines will clarify best practices for health care providers across the continuum of care of STEMI patients."

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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