Chapter 34. An Integrated Approach to the Management of Patients after the Early Phase of ST Segment Elevation Myocardial Infarction

  1. Salim Yusuf DPhil, FRCPC, FRSC Research Chair Professor of Medicine Director Vice President Research3,4,5,
  2. John A Cairns MD, FRCPC Professor of Medicine Former Dean6,
  3. A John Camm MD British Heart Foundation Professor Head of Cardiac7,
  4. Ernest L Fallen MD, FRCPC Professor Emeritus8 and
  5. Bernard J Gersh MB, ChB, DPhil Consultant Professor of Medicine9
  1. Pedro L Sánchez MD, PhD Head of Section Associate Professor1 and
  2. Francisco Fernández-Avilés PhD, MD Professor of Medicine Head2

Published Online: 21 MAY 2010

DOI: 10.1002/9781444309768.ch34

Evidence-Based Cardiology, Third Edition

Evidence-Based Cardiology, Third Edition

How to Cite

Sánchez, P. L. and Fernández-Avilés, F. (2009) An Integrated Approach to the Management of Patients after the Early Phase of ST Segment Elevation Myocardial Infarction, in Evidence-Based Cardiology, Third Edition (eds S. Yusuf, J. A. Cairns, A. J. Camm, E. L. Fallen and B. J. Gersh), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444309768.ch34

Editor Information

  1. 3

    McMaster University, Canada

  2. 4

    Population Health Research Institute, McMaster University, Hamilton Health Sciences, Canada

  3. 5

    Hamilton Health Sciences, Hamilton, Ontario, Canada

  4. 6

    Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

  5. 7

    St George's University of London, London, UK

  6. 8

    McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada

  7. 9

    Mayo Clinic College of Medicine, Rochester, MN, USA

Author Information

  1. 1

    Department of Cardiology, Hospital General Universitario Gregorio Marañón, School of Medicine, Complutense University, Madrid, Spain

  2. 2

    Department of Cardiology, Hospital General Universitario Gregorio Marañón, Complutense University, School of Medicine, Madrid, Spain

Publication History

  1. Published Online: 21 MAY 2010
  2. Published Print: 13 NOV 2009

ISBN Information

Print ISBN: 9781405159258

Online ISBN: 9781444309768

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Keywords:

  • antiplatelet treatment;
  • antithrombotic

Summary

The principal aim of early management in patients with ST-segment elevation myocardial infarction is the restoration of normal flow in the infarct-related artery. Whether this is attempted mechanically or pharmacologically, adjunctive antithrombotic therapy is critical in establishing and maintaining vessel patency. The last decade has seen a rapid expansion in the antithrombotic armamentarium. Whilst the development of novel agents has tended to focus on reducing thrombotic and ischaemic complications, the importance of mitigating bleeding risk is increasingly recognised. Although the adverse effects of many bleeding events are clear, the relationship between bleeding and ischaemic events is complex and remains only partly understood. This chapter will examine evidence for antithrombotic use in patients with acute STEMI with an emphasis on the balance between efficacy and safety.