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Autor: Grafiati

Data publikacji: 7 czerwca 2025

Data aktualizacji: 2 sierpnia 2025

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1

Bays de Luna, A., M. Fiol-Sala, and E. M. Antman, eds. The 12-Lead ECG in ST Elevation Myocardial Infarction. Blackwell Publishing, Inc., 2007. http://dx.doi.org/10.1002/9780470750964.

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Pharand, Chantal. The use of platelet glycoprotein IIB/IIIA receptor antagonists in the management of unstable angina and non-st-elevation myocardial infarction: A critical evaluation. s.n., 2000.

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Erlinge, David, and Göran Olivecrona. Diagnosis and management of ST-elevation of myocardial infarction. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0147.

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ST-elevation myocardial infarction (STEMI) is generally caused by a ruptured plaque that triggers local thrombus formation, which occludes the coronary artery. STEMI should be diagnosed rapidly, based on the combination of ST-segment elevation and symptoms of acute myocardial infarction. The main treatment objective is myocardial tissue reperfusion as quickly as possible. The preferred method of reperfusion is primary percutaneous coronary interventionif transport time is below 2 hours, and thrombolysis if longer STEMI patients with acute onset cardiogenic shock should be evaluated by echocard

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4

Huber, Kurt, and Tom Quinn. Systems of care for patients with acute ST elevation myocardial infarction (STEMI networks). Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0042.

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Although primary percutaneous coronary intervention is the preferred strategy for patients with ST elevation myocardial infarction, offering a fast access to this procedure often remains difficult, because of local resources and capabilities and a lack of cooperation and organization. Accordingly, for most countries worldwide, primary percutaneous coronary intervention can be provided for only part of the population. Moreover, not all patients referred for primary percutaneous coronary intervention receive an optimal mechanical reperfusion within the recommended time intervals with the procedu

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5

Huber, Kurt, and Tom Quinn. Systems of care for patients with acute ST elevation myocardial infarction (STEMI networks). Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0042_update_001.

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Although primary percutaneous coronary intervention is the preferred strategy for patients with ST elevation myocardial infarction, offering a fast access to this procedure often remains difficult, because of local resources and capabilities and a lack of cooperation and organization. Accordingly, for most countries worldwide, primary percutaneous coronary intervention can be provided for only part of the population. Moreover, not all patients referred for primary percutaneous coronary intervention receive an optimal mechanical reperfusion within the recommended time intervals with the procedu

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Huber, Kurt, and Tom Quinn. Systems of care for patients with acute ST elevation myocardial infarction (STEMI networks). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0042_update_002.

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Although primary percutaneous coronary intervention is the preferred strategy for patients with ST elevation myocardial infarction, offering a fast access to this procedure often remains difficult, because of local resources and capabilities and a lack of cooperation and organization. Accordingly, for most countries worldwide, primary percutaneous coronary intervention can be provided for only part of the population. Moreover, not all patients referred for primary percutaneous coronary intervention receive an optimal mechanical reperfusion within the recommended time intervals with the procedu

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7

Shirodaria, Cheerag, and Sam Dawkins. Acute coronary syndromes. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0090.

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The term ‘acute coronary syndrome’ includes unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI). The difference between these three syndromes is as follows. In STEMI and NSTEMI, there is evidence of myocardial necrosis, as evidenced by raised cardiac enzymes, specifically, the very sensitive cardiac biomarker troponin. STEMI is diagnosed when the ECG shows persisting ST elevation in an appropriate territory consistent with STEMI whereas, in NSTEMI, there can be any or no ECG changes, or very transient, self-limiting ST elevation. In

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8

Erlinge, David, and Göran Olivecrona. Diagnosis and management of non-STEMI coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0146.

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Acute coronary syndromes are classified as ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or unstable angina. Most patients with NSTEMI present with a history of chest pain that has subsided spontaneously before or soon after arrival at the emergency room, but with positive cardiac markers (usually troponin T or I) indicative of myocardial infarction. NSTEMI has a risk of recurrent myocardial infarction of 15–20% and a 15% chance of 1-year mortality. Patients with non-STE-acute coronary syndromes are at similar risk as a STEMI patient at 1 year. The strongest objective

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9

D’Auria, Stephen, and Ravi Ramani. Chest Pain and Acute Coronary Syndrome (DRAFT). Edited by Raghavan Murugan and Joseph M. Darby. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190612474.003.0011.

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Chest pain is a common presenting complaint faced by the rapid response team (RRT), and can herald a serious process such as acute coronary syndrome or aortic dissection, or be secondary to a minor muscle strain. A methodical approach to chest pain is necessary to avoid premature diagnostic closure. One of the most feared diagnoses is a myocardial infarction. Fortunately, there are well-established guidelines describing the necessary steps for treatment of both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). This chapter will address the differen

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10

Dawson, Dana, and Keith Fox. Anti-Platelet and Anti-Thrombotic Therapy Post-AMI. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0004.

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• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical out

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11

Kisiel, Maria, and Alison Smith. Cardiac surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642663.003.0026.

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Coronary heart disease is caused by the build-up of atherosclerotic plaques which, over time, narrow the lumen of the coronary arteries. Acute coronary syndrome describes a spectrum of conditions caused by coronary artery disease; these are unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI). Coronary artery disease is the leading cause for cardiac surgical interventions, but other causes are hypertension, valve disease, arrhythmias, cardiomyopathies, infections, and congenital abnormalities. This chapter provides an overview of the

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12

AlJaroudi, Wael. Risk Assessment in Acute Coronary Syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0013.

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Acute coronary syndromes (ACS) include unstable angina pectoris (UAP), non-ST elevation (NSTEMI), and ST elevation acute myocardial infarction (STEMI). Each year, more than 2 million people are hospitalized with ACS in the United States. The initial treatment has evolved over the last few decades from conservative management to early reperfusion therapy. Medical therapy has also significantly changed with the use of newer more potent antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors, statins, and anti-anginal drugs, which have resulted in improvement of patient care

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13

Banerjee, Ashis, and Clara Oliver. Cardiac emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198786870.003.0009.

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Chest pain is a common presenting complaint for patients in the emergency department. This chapter focuses on the management and recent changes to non-ST-segment elevation myocardial infarction (NSTEMI) and STEMI pathways, in keeping with national guidance. Arrhythmia management including atrial fibrillation as well as the use of scoring systems as the CHADVASC score also commonly appears in the short-answer question (SAQ) paper, which is covered in this chapter in line with current NICE guidance. In addition, there is also a section on the diagnosis and differentiation on managing a patient w

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14

Cheong, Adrian, Gabriel Steg, and Stefan K. James. ST-segment elevation myocardial infarction. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0043.

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Acute myocardial infarction with ST-segment elevation is a common and dramatic manifestation of coronary artery disease. It is caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to its total thrombotic occlusion and resultant ischaemia and necrosis of downstream myocardium. The diagnosis of ST-segment elevation myocardial infarction is based on a syndrome of ischaemic chest pain symptoms, associated with typical ST-segment elevation on the electrocardiogram and an eventual rise in biomarkers of myocardial necrosis. The treatment of ST-segment elevation myocardial

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15

Frostfeldt, Gunnar. Coagulation Inhibition & Development of Myocardial Damage in St-Elevation Myocardial Infarction. Uppsala Universitet, 2002.

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16

Hoque, Azizul, Chowdhury Ahsan, and Aaysha Cader. Handbook of Management of Acute ST-Elevation Myocardial Infarction. BD Physicians, 2021.

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17

Cheong, Adrian P., Gabriel Steg, and Stefan K. James. ST-segment elevation MI. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0043_update_001.

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Acute myocardial infarction with ST-segment elevation is a common and dramatic manifestation of coronary artery disease. It is caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to its total thrombotic occlusion and resultant ischaemia and necrosis of downstream myocardium. The diagnosis of ST-segment elevation myocardial infarction is based on a syndrome of ischaemic chest pain symptoms, associated with typical ST-segment elevation on the electrocardiogram and an eventual rise in biomarkers of myocardial necrosis. The treatment of ST-segment elevation myocardial

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18

Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Acute myocardial infarction. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.0596_update_004.

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Diagnosis and current therapy of ST elevation myocardial infarction are presented. Recent recommendations by the ACC/AHA and the ESC on primary PCI and fibrinolysis have been summarized and tabulated.

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19

Luna, Antonio Bayés de, Elliot M. Antman, and Miquel Fiol-Sala. 12-Lead ECG in ST Elevation Myocardial Infarction: A Practical Approach for Clinicians. Wiley & Sons, Limited, John, 2007.

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20

Luna, Antonio Bayés de, Miguel Fiol-Sala, Elliot M. Antman, and Antonio BayéS De Luna. The 12 Lead ECG in ST Elevation Myocardial Infarction: A Practical Approach for Clinicians. Blackwell Publishing Limited, 2007.

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21

Malcolm, Jackie. Medical versus surgical management in unstable angina and non-ST-elevation myocardial infarction. 2001.

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22

Antman, Elliot M., Miquel Fiol-Sala, and Antoni Bayés de Luna. 12 Lead ECG in ST Elevation Myocardial Infarction: A Practical Approach for Clinicians. Wiley & Sons, Incorporated, John, 2008.

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23

Antman, Elliot M., Miquel Fiol-Sala, and Antoni Bayés de Luna. 12 Lead ECG in ST Elevation Myocardial Infarction: A Practical Approach for Clinicians. Wiley & Sons, Incorporated, John, 2008.

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24

Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Non-ST elevation acute coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.0538_update_004.

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Diagnosis and current pharmacological and interventional management of unstable angina/non-ST elevation myocardial infarction are presented in this chapter. Recent recommendations by the ACC/AHA and the ESC have been summarized and tabulated.

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25

López-Sendón, José, and Esteban López de Sá. Mechanical complications of myocardial infarction. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0045.

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Mechanical complications after an acute infarction include different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies but may occur in 2–3% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment. Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent chest pain. Awarenes

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26

López-Sendón, José, and Esteban López de Sá. Mechanical complications of myocardial infarction. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0045_update_001.

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Mechanical complications after an acute infarction include different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies but may occur in 2–3% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment. Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent chest pain. Awarenes

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López-Sendón, José, and Esteban López de Sá. Mechanical complications of myocardial infarction. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0045_update_002.

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Mechanical complications after an acute infarction include different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies but may occur in 2–3% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment. Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent chest pain. Awarenes

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28

López-Sendón, José, and Esteban López de Sá. Mechanical complications of myocardial infarction. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0045_update_003.

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Mechanical complications after an acute infarction involve different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies occurring in <1% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment (Ibanez et al, 2017). Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent c

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29

Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0046.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatme

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Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0046_update_001.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatme

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31

Bueno, Héctor, and José A. Barrabés. Non-ST-segment elevation acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0046_update_002.

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Non-ST-segment elevation acute coronary syndromes are life-threatening disorders, usually caused by acute coronary thrombosis and subsequent myocardial ischaemia, presenting without persistent ST-segment elevation in the initial electrocardiogram. According to the occurrence of myocardial necrosis, non-ST-segment elevation acute coronary syndromes are divided into non-ST-segment myocardial infarction or unstable angina. The management of non-ST-segment elevation acute coronary syndromes requires an early diagnosis and risk stratification, urgent hospitalization, monitoring, and medical treatme

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32

Agency for Healthcare Research and Quality and U.S. Department of Health and Human Services. Antiplatelet and Anticoagulant Treatments for Unstable Angina/Non-ST Elevation Myocardial Infarction: Comparative Effectiveness Review Number 129. CreateSpace Independent Publishing Platform, 2013.

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Valgimigli, Marco, and Marco Angelillis. Treatment of non-ST elevation acute coronary syndromes. Edited by Stefan James. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0311.

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Treatment of patients presenting with a non-ST elevation acute coronary syndrome (NSTE-ACS) aims at immediate relief of ischaemia and the prevention of serious adverse events, including death, myocardial (re)infarction, and life-threatening arrhythmias. In NSTE-ACS, patient management is guided by risk stratification (troponin, electrocardiogram, risk scores, etc.). Treatment options include anti-ischaemic and antithrombotic drugs and coronary revascularization including percutaneous coronary interventions, or coronary artery bypass grafting. While long-term secondary prevention with aspirin m

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34

Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Epidemiology and pathophysiology of coronary artery disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.0529_update_004.

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This chapter presents the epidemiology and pathophysiology of stable ischaemic heart disease and acute coronary syndromes, i.e. unstable angina/non-ST elevation myocardial infarction and ST elevation myocardial infarction.

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35

Carton, James. Cardiac pathology. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199591633.003.0004.

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Congenital heart disease 40Angina pectoris 42Unstable angina 43Non-ST-elevation myocardial infarction 44ST-elevation myocardial infarction 46Left ventricular failure 48Right ventricular failure 50Valvular heart disease 51Cardiomyopathies 52Infective endocarditis 53Myocarditis 54Pericarditis 55• Most common type of congenital heart disease (CHD)....

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36

Carton, James. Cardiac pathology. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759584.003.0004.

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This chapter covers cardiac pathology, including congenital heart disease (CHD), angina pectoris, unstable angina, non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, left ventricular failure (LVF), right ventricular failure (RVF), valvular heart disease, cardiomyopathies, infective endocarditis, myocarditis, and pericarditis.

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Ramrakha, Punit, and Jonathan Hill, eds. Cardiovascular emergencies. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199643219.003.0017.

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Adult basic life support 710Adult advanced life support 712Universal treatment algorithm 716Primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction 718Acute MI: thrombolysis protocol 719Acute myocardial infarction 720Treatment options in tachyarrhythmias 721Ventricular tachycardia: drugs 722Supraventricular tachyarrhythmias ...

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Macleod, Dr Donald C., Dr Ian Scott, Professor Calum Archibald Macrae, et al. Cardiac diseases and resuscitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199565979.003.0004.

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Chapter 4 discusses cardiac diseases and resuscitation, including symptoms, signs, and diagnostic investigations in cardiac disease, adult cardiopulmonary resuscitation, cardiovascular risk assessment, heart failure, acute coronary syndromes, arrhythmias, hypertension and hypertensive emergencies, thromboembolic disease, valvular disease, infective endocarditis, cardiomyopathies, congenital heart disease, heart disease in pregnancy, diseases of arteries and veins, rheumatic fever, pericarditis, ST segment elevation, and myocardial infarction.

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Wiffen, Philip, Marc Mitchell, Melanie Snelling, and Nicola Stoner. Therapy-related issues: cardiovascular system. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735823.003.0016.

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This chapter is aimed at junior hospital pharmacists and community pharmacists and is loosely based on the British National Formulary, Chapter 2. It covers diagnosis, symptoms, and treatment management plans for a variety of cardiovascular topics including hypertension, heart failure, and angina, and additional topics that cover issues related to anticoagulation, acute coronary syndromes, ST-segment elevation myocardial infarction, and cardiopulmonary resuscitation.

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Visser, Frans, and Maarten Simoons. Percutaneous Coronary Intervention and Thrombolysis in AMI & other ACS. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0003.

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• Acute coronary syndromes (ACS) comprise an evolving acute myocardial infarction (AMI) presenting with or without ST-elevation and unstable angina• Patients presenting with an ST-elevation MI require immediate reperfusion therapy by primary percutaneous coronary intervention (PCI) or, if such is not available, thrombolysis• Cardiologists, emergency care physicians, general practictioners and ambulance services should collaborate to develop a national or regional system to optimise AMI therapy, given the national or local facilities and available resources• A subgroup of high-risk patients pre

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Nihoyannopoulos, Petros, and Fausto Pinto. Ischaemic heart disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0012.

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Echocardiography with its multiple modalities plays a central role in the evaluation of patients with known or suspected coronary artery disease, starting from the differential diagnosis of the patient presenting with acute chest pain. In the patient presenting with acute myocardial infarction (raised troponins) whether it is with ST-segment elevation or without, echocardiography is the first imaging modality used in order to ascertain the presence and extent of LV dysfunction and the presence of complications. In the absence of myocardial infarction (negative troponins), echocardiography will

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42

Reffelmann, Thorsten, and Robert Kloner. Adjunctive Reperfusion Therapy Post-AMI. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0009.

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• Reperfusion of the occluded coronary artery in an ST-segment-elevation myocardial infarction is the most effective approach for reducing infarct size, preserving left ventricular ejection fraction, lowering the incidence and severity of congestive heart failure and improving prognosis• Hence, several pharmacologic agents intended to improve target vessel patency as an adjunct to thrombolysis or primary percutaneous coronary intervention have been shown to be beneficial in patients with reperfusion therapy for acute myocardial infarction, namely antiplatelet and anticoagulation agents• Animal

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Kočka, Viktor, Steen Dalby Kristensen, William Wijns, Petr Toušek, and Petr Widimský. Percutaneous coronary interventions in acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0047.

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Three different guidelines of the European Society of Cardiology cover the field of percutaneous coronary interventions. Their main recommendations are the following:All patients with an ST-segment elevation myocardial infarction should undergo immediate coronary angiography and percutaneous coronary intervention as soon as possible after the first medical contact. Thrombolysis can be used as an alternative reperfusion therapy if the time delay to primary percutaneous coronary intervention is more than 2 hoursPatients with very high-risk non-ST-segment elevation acute coronary syndromes (recur

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44

Kočka, Viktor, Steen Dalby Kristensen, William Wijns, Petr Toušek, and Petr Widimský. Percutaneous coronary interventions in acute coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0047_update_001.

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Three different guidelines of the European Society of Cardiology cover the field of percutaneous coronary interventions. Their main recommendations are the following:All patients with an ST-segment elevation myocardial infarction should undergo immediate coronary angiography and percutaneous coronary intervention as soon as possible after the first medical contact. Thrombolysis can be used as an alternative reperfusion therapy if the time delay to primary percutaneous coronary intervention is more than 2 hoursPatients with very high-risk non-ST-segment elevation acute coronary syndromes (recur

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45

Kočka, Viktor, Steen Dalby Kristensen, William Wijns, Petr Toušek, and Petr Widimský. Percutaneous coronary interventions in acute coronary syndromes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0047_update_002.

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Three different guidelines of the European Society of Cardiology cover the field of percutaneous coronary interventions. Their main recommendations are the following: All patients with an ST-segment elevation myocardial infarction should undergo immediate coronary angiography and percutaneous coronary intervention as soon as possible after the first medical contact. Thrombolysis can be used as an alternative reperfusion therapy if the time delay to primary percutaneous coronary intervention is more than 2 hours. Patients with very high-risk non-ST-segment elevation acute coronary syndromes (re

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Kočka, Viktor, Steen Dalby Kristensen, William Wijns, Petr Toušek, and Petr Widimský. Percutaneous coronary interventions in acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0047_update_003.

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Three different guidelines of the European Society of Cardiology cover the field of percutaneous coronary interventions. Their main recommendations are the following: All patients with an ST-segment elevation myocardial infarction should undergo immediate coronary angiography and percutaneous coronary intervention as soon as possible after the first medical contact. Thrombolysis can be used as an alternative reperfusion therapy if the time delay to primary percutaneous coronary intervention is more than 2 hours. Patients with very high-risk non-ST-segment elevation acute coronary syndromes (re

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Sinnaeve, Peter, and Frans Van de Werf. Fibrinolytic, antithrombotic, and antiplatelet drugs in acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0044.

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Antithrombotic therapy is a major cornerstone in the treatment for acute coronary syndromes, as thrombus formation upon a plaque rupture or an erosion plays a pivotal role in non-ST-segment elevation as well as ST-segment elevation acute coronary syndromes. Both acute and long-term oral antiplatelet therapies, targeting specific platelet activation pathways, have demonstrated significant short- and long-term benefits. The use of anticoagulants is currently largely confined to the acute setting, except in patients with a clear indication for long-term treatment, including atrial fibrillation or

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Sinnaeve, Peter, and Frans Van de Werf. Fibrinolytic, antithrombotic, and antiplatelet drugs in acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0044_update_001.

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Antithrombotic therapy is a major cornerstone in the treatment for acute coronary syndromes, as thrombus formation upon a plaque rupture or an erosion plays a pivotal role in non-ST-segment elevation as well as ST-segment elevation acute coronary syndromes. Both acute and long-term oral antiplatelet therapies, targeting specific platelet activation pathways, have demonstrated significant short- and long-term benefits. The use of anticoagulants is currently largely confined to the acute setting, except in patients with a clear indication for long-term treatment, including atrial fibrillation or

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Bell, Robert M. Pathophysiology of coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0145.

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The pathophysiology of acute coronary syndromes is characterized by an acute mismatch of blood supply to the myocardium to meet the prevailing metabolic need. By far the commonest aetiology of myocardial ischaemia is coronary artery disease . An inflammatory process that evolves over the period of many decades, coronary artery disease is characterized by the deposition of cholesterol and cholesterol laden macrophages within the intima of the vessel wall. This process can be accelerated by a number of cardiovascular risk factors (smoking, hypertension, hyperlipidaemia, hypercholesterolaemia, di

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Verheugt, Freek W. A. Fibrinolytic therapy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0038.

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Fibrinolytic agents are able to reopen blood vessels that are occluded by a fresh thrombus. Urokinase, streptokinase, and streptokinase derivatives were the first effective agents. Recombinant plasminogen activators became available and they are specific for thrombus-bound fibrin. Significant bleeding is the major side effect of fibrinolysis, a major hurdle for its use. The current era of mechanical reperfusion has made fibrinolytic therapy a niche treatment for acute arterial thrombosis such as ST elevation myocardial infarction and stroke. Only for pulmonary embolism with haemodynamic conseq

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