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STEMI treatment guidelines

STEMI guidelines state that acute myocardial ischaemia (<12 h) should be treated with reperfusion therapy1,2. Guidelines from the ACC/AHA1 and ESC2 agree that:

  1. Primary PCI (PPCI) is the gold-standard of reperfusion treatment for STEMI if delivered ≤120 minutes of diagnosis.

  2. Where this is not possible, fibrinolysis should be performed with a fibrin-specific agent (tenecteplase, alteplase or reteplase) as soon as possible within 10 min from STEMI diagnosis, preferably pre-hospital, alongside adjunctive antiplatelet and anticoagulant therapies, and patients should be transferred to a PCI-capable centre for subsequent therapy.

 

STEMI treatment guidelines

ACC/AHA, American College of Cardiology/American Heart Association
ESC, European Society of Cardiology
PPCI, primary percutaneous coronary intervention

Huber, Kurt

To discover more about current STEMI guidelines, see our virtual symposium video by Kurt Huber.

Robert Welsh

For more information on tailoring STEMI treatment to achieve optimal efficacy with minimal risk, see our virtual symposium video by Robert Welsh

References: 

  1. O’Gara PT et al. 2013 ACCF/AHA Guideline for the management of ST-Elevation myocardial infarction: A report of the American college of cardiology foundation/American Heart Association task force on practice guidelines. Circulation 2013;127:e362-e425.

  2. Ibanez B et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39(2):119-177.