Time for a new paradigm shift in myocardial infarction

Aslanger E. K., Meyers H. P., Smith S. W.

ANATOLIAN JOURNAL OF CARDIOLOGY, cilt.25, sa.3, ss.156-162, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 25 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.5152/anatoljcardiol.2021.89304
  • Dergi Adı: ANATOLIAN JOURNAL OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.156-162
  • Anahtar Kelimeler: acute coronary syndrome, coronary artery disease, coronary occlusion, electrocardiogram, myocardial infarction, ST-SEGMENT ELEVATION, ACUTE CORONARY SYNDROMES, ASSOCIATION TASK-FORCE, PRACTICE GUIDELINES COMMITTEE, DELAYED INVASIVE INTERVENTION, AMERICAN-COLLEGE, ACC/AHA GUIDELINES, UNSTABLE ANGINA, MANAGEMENT, IMMEDIATE
  • Marmara Üniversitesi Adresli: Evet

Özet

The ST-elevation myocardial infarction (STEMI)/non-STEMI paradigm per the current guidelines has important limitations. It misses a substantial proportion of acute coronary occlusions (ACO) and results in a significant amount of unnecessary catheterization laboratory activations. It is not widely appreciated how poor is the evidence base for the STEMI criteria; the recommended STEMI cutoffs were not derived by comparing those with ACO with those without and not specifically designed for distinguishing patients who would benefit from emergency reperfusion. This review aimed to discuss the origins, evidence base, and limitations of STEMI/non-STEMI paradigm and to call for a new paradigm shift to the occlusion MI (OMI)/non-OMI.