Key result
Adjunctive antithrombotic drugs and percutaneous thrombectomy during primary PCI for STEMI are crucial to manage thrombotic lesions and improve angiographical and clinical outcomes.
This review highlights the prognostic importance of coronary thrombus in STEMI and the role of adjunctive antithrombotic and thrombectomy strategies during primary PCI.
May inform thrombus management in STEMI PCI; leaves open optimal strategies pending randomized confirmation.
Acute ST-elevation myocardial infarction (STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator, which is mostly proportional to their size and composition. Particularly, intracoronary thrombi impair both epicardial blood flow and myocardial perfusion, by occluding major coronary arteries and causing distal embolization, respectively. Thus, although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting, the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients, by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used in the setting of STEMI to manage thrombotic lesions.
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Sabine Vecchio (2014) conducted a review in Acute ST-elevation myocardial infarction (STEMI). Antithrombotic drugs and percutaneous thrombectomy was evaluated. Adjunctive antithrombotic drugs and percutaneous thrombectomy during primary PCI for STEMI are crucial to manage thrombotic lesions and improve angiographical and clinical outcomes.
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