Key result
Early initiation of reperfusion therapy for ST-elevation acute coronary syndromes, ideally at the patient's home or in the ambulance, maximizes myocardial salvage and lives saved.
Highlights the critical importance of minimizing time-to-treatment in STEMI by initiating reperfusion therapy in the prehospital setting.
Reperfusion therapy for ST-elevation acute coronarysyndromes aims at early and complete recanalizationof the infarct-related artery in order to salvage myo-cardium and improve both early and late clinical outcomes. The benefit rises exponentially the earlier therapy is initiated. The highest number of lives saved is within the first hour after symptom onset: the “golden hour. ” The exponential form of the curve relating mortality to time-to-reperfusion has major implications for the timing of treatment. The impact of delay in time-to-treatment lessens as the duration of ischemia lengthens. Consequently, reducing delays will have a much more positive return in patients presenting early for those presenting late. These considerations have provided a strong incentive for the initiation of very early reperfusion therapy. Article p 2398 The optimal site for initiation of reperfusion strategies is the patient’s home or place where the infarction occurs.
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Freek W.A. Verheugt (2006) conducted an editorial in ST-elevation acute coronary syndromes. Early reperfusion therapy was evaluated. Early initiation of reperfusion therapy for ST-elevation acute coronary syndromes, ideally at the patient's home or in the ambulance, maximizes myocardial salvage and lives saved.
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