FAILED PREHOSPITAL FIBRINOLYSIS IN PATIENT WITH PERCUTANEOUS CORONARY INTERVENTION IN ST-ELEVATION MYOCARDIAL INFARCTION

  • O. S. Makharynska V. N. Karazin Kharkiv National University https://orcid.org/0000-0001-5326-1587
  • I. I. Oktiabrova V. N. Karazin Kharkiv National University
  • H. Yu. Kartvelishviliy Kharkiv Railway Clinical Hospital No. 1 of Brenche of «HC» JSC «Ukrzaliznytsia»
  • O. O. Okhryamkina Kharkiv Railway Clinical Hospital No. 1 of Brenche of «HC» JSC «Ukrzaliznytsia»
Keywords: STEMI, thrombolysis, effective treatment, coronarography

Abstract

On the example of the clinical case of newly diagnosed ST-elevation myocardial infarction combination of different reperfution strategies and their benefit was discussed. Recommendations on lifestyle modification and medicament treatment tactics are described. From one hand, in spite of side-effects of treatment as an increased risk of stroke and hemorrhagic stroke, prehospital FL is associated with a decreased risk of cardiogenic shock and its effectiveness depends on the time from symptom onset to reperfusion. From other hand, despite the fact that PPCI is the recommended default reperfusion strategy, its effectiveness depends also on time limits and absence of the majority of PPCI-facilated hospitals worldwide. Combination of prehospital single-bolus FL following after 3–24h early routine angiography and PCIcan improve post-STEMI survival and help to avoid hyperreactivity and thrombin-induced platelet activation after FL, which can be a key to success in effective treatment and rehabilitationafter STEMI in patients without high risk factors of potential bleeding or stroke.

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Author Biographies

O. S. Makharynska, V. N. Karazin Kharkiv National University

Svobody sq., 6, Kharkiv, 61022, Ukraine

I. I. Oktiabrova, V. N. Karazin Kharkiv National University

Svobody sq., 6, Kharkiv, 61022, Ukraine

H. Yu. Kartvelishviliy, Kharkiv Railway Clinical Hospital No. 1 of Brenche of «HC» JSC «Ukrzaliznytsia»

Kharkiv, Ukraine

O. O. Okhryamkina, Kharkiv Railway Clinical Hospital No. 1 of Brenche of «HC» JSC «Ukrzaliznytsia»

Kharkiv, Ukraine

References

2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation / [B. Ibanez, S. James, S. Agewall, et al.] // European Heart Journal. – 2017. – No. 00. – p. 1–66.

Sutton A.G. A randomized trial of rescue angioplasty versus a conservative approach for failed fibrinolysis in ST-segment elevation myocardial infarction: the Middlesbrough Early Revascularization to Limit INfarction (MERLIN) trial. / [A. G. Sutton, P. G. Campbell, R. Graham, et al.] // J Am Coll Cardiol. – 2004. – No. 44 (2). – p. 287.

Roule V. Prehospital fibrinolysis versus primary percutaneous coronary intervention in ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized controlled trials / [V. Roule, P. Ardouin, K. Blanchar, et al.] // Critical Care. – 2016. – No. 20. – p.359.

Jordan M. Improving door-to-needle times for patients presenting with ST-elevation myocardial infarction at a rural district general hospital / M. Jordan, J. Caesar // BMJ Quality Improvement Reports. – 2016. – No. 5. – p. 1–10.

Wang T. Y. Association of door-in to door-out time with reperfusion delays and outcomes among patients transferred for primary percutaneous coronary intervention. / [T. Y. Wang, B. K. Nallamothu, H. M. Krumholz, et al.]. // JAMA. – 2011. – No. 305 (24). – p. 2540–2547.

Madan M. Relationship between time to invasive assessment and clinical outcomes of patients undergoing an early invasive strategy after fibrinolysis for ST-segment elevation myocardial infarction: a patient-level analysis of the randomized early routine invasive clinical trials. / [M. Madan, S. Halvorsen, C. Di Mario, et al.]. JACC Cardiovasc Interv. – 2015. – No. 8. – p. 166–174.

Published
2018-06-29
How to Cite
Makharynska, O. S., Oktiabrova, I. I., Kartvelishviliy, H. Y., & Okhryamkina, O. O. (2018). FAILED PREHOSPITAL FIBRINOLYSIS IN PATIENT WITH PERCUTANEOUS CORONARY INTERVENTION IN ST-ELEVATION MYOCARDIAL INFARCTION. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (35), 113-117. https://doi.org/10.26565/2313-6693-2018-35-19