September 1, 2009
View Full PaperST Elevation Myocardial Infarction Guidelines Today: A Systematic Review Exploring Updated ACC/AHA STEMI Guidelines and Their Applications
Key Result
The updated ACC/AHA STEMI guidelines provide revised recommendations for reperfusion, antithrombotic therapy, fibrinolysis, and primary percutaneous intervention to improve patient outcomes.
Study Design
Type
Systematic Review
Structured PICO
P
Population
Patients with ST elevation myocardial infarctions (STEMI)
I
Intervention
Updated ACC/AHA STEMI guidelines (including recommendations on reperfusion, antithrombotic therapy, ancillary anticoagulation, fibrinolytic therapy, and primary PCI)
This systematic review highlights the importance of adhering to updated ACC/AHA STEMI guidelines, particularly regarding reperfusion and antithrombotic therapies, to optimize patient outcomes.
Abstract
With new study findings becoming available, the American College of Cardiology (ACC) and the American Heart Association (AHA) have made additions and revisions to their guidelines for treating patients with ST elevation myocardial infarctions (STEMI). It is important for clinicians to be familiar with these changes so that they may be applied and assist in the treatment of patients. Electronic searches on databases such as PubMed, Cochrane Library, and Medline were conducted using specific keywords pertaining to the ACC/AHA guidelines and the specific topics discussed in these guidelines to find randomized controlled trials, meta-analyses, and systematic reviews. Additional studies were then found via hand search for referenced sources. All sources were then stratified on quality and relevance. The ACC/AHA have made several additions and revisions to the 2004 STEMI guidelines. These include recommendations focusing on reperfusion and antithrombotic therapy, ancillary anticoagulation, fibrinolytic therapy, and primary percutaneous intervention (PCI). Goal times for interventions such as fibrinolytic therapy and PCI are also set forth in new guidelines, which stress prompt response to STEMI for better outcomes. Changes deal with all aspects of care such as care provided by emergency medical systems (EMS) en route to the hospital, in-hospital fibrinolysis and PCI, post-hospitalization measures, and secondary prevention. It is of great importance that clinicians who deal with STEMI become familiar with the latest guidelines so that the quality of care they provide is of the highest caliber and that patients experience the highest quality of life after STEMI treatment.