AMI: The scale of the problem
(1 September 2009: VIDYYA MEDICAL NEWS SERVICE) -- Acute myocardial infarction (AMI) remains one of the leading causes of death in the Western world, with prevalence predicted to increase dramatically in developing countries, especially India and China. Around 40-50% of AMIs are the result of a persistent, complete thrombotic occlusion of a coronary artery. In such cases fast reopening of the infarct vessel is the primary goal of treatment.
This "reperfusion" therapy has been shown to save lives, especially when applied with 2-3 hours after the onset of infarction. Recanalisation of the infarct vessel can be obtained by administering thrombolytic agents (to dissolve the occlusive thrombus) or by performing a mechanical recanalisation followed by angioplasty of the culprit lesion (primary percutaneous intervention, PCI).
Primary PCI can open significantly more vessels than thrombolytic therapy, and therefore save more lives, but it can only be performed in facilities with a cath lab and an experienced team on stand-by.
Getting patients with an AMI to a PCI centre in the shortest possible time is a major challenge which requires a close collaboration between cardiologists of different hospitals and the emergency medical system. The ESC and health authorities in different countries are currently taking many initiatives to set-up these networks.
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