Beyond STEMI-NSTEMI Paradigm: Dante Pazzanese's Proposal for Occlusion Myocardial Infarction Diagnosis.

Arquivos brasileiros de cardiologia Pub Date : 2024-07-15 eCollection Date: 2024-01-01 DOI:10.36660/abc.20230733
José Nunes De Alencar, Fausto Feres, Mariana Fuziy Nogueira De Marchi, Kleber Gomes Franchini, Matheus Kiszka Scheffer, Sandro Pinelli Felicioni, Ana Carolina Muniz Costa, Rinaldo Carvalho Fernandes, Hugo Ribeiro Ramadan, Pendell Meyers, Stephen W Smith
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Abstract

Although the existing framework for classifying acute myocardial infarction (AMI) into STEMI and NSTEMI has been beneficial, it is now considered to be falling short in addressing the complexity of acute coronary syndromes. The study aims to scrutinize the current STEMI-NSTEMI paradigm and advocate for a more nuanced framework, termed as occlusion myocardial infarction (OMI) and non-occlusion myocardial infarction (NOMI), for a more accurate diagnosis and management of AMI. A comprehensive analysis of existing medical literature was conducted, with a focus on the limitations of the STEMI-NSTEMI model. The study also outlines a new diagnostic approach for patients presenting with chest pain in emergency settings. The traditional STEMI-NSTEMI model falls short in diagnostic precision and effective treatment, especially in identifying acute coronary artery occlusions. The OMI-NOMI framework offers a more anatomically and physiologically accurate model, backed by a wealth of clinical research and expert opinion. It underscores the need for quick ECG assessments and immediate reperfusion therapies for suspected OMI cases, aiming to improve patient outcomes. The OMI-NOMI framework offers a new avenue for future research and clinical application. It advocates for a more comprehensive understanding of the underlying mechanisms of acute coronary syndromes, leading to individualized treatment plans. This novel approach is expected to ignite further scholarly debate and research, particularly in the Brazilian cardiology sector, with the goal of enhancing diagnostic accuracy and treatment effectiveness in AMI patients.

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超越 STEMI-NSTEMI 范式:Dante Pazzanese 关于闭塞性心肌梗塞诊断的建议。
尽管将急性心肌梗死(AMI)分为 STEMI 和 NSTEMI 的现有框架一直很有益处,但现在人们认为该框架不足以应对急性冠状动脉综合征的复杂性。本研究旨在对目前的 STEMI-NSTEMI 范式进行仔细研究,并提倡采用一种更细致的框架,即闭塞性心肌梗死(OMI)和非闭塞性心肌梗死(NOMI),以更准确地诊断和管理急性冠状动脉综合征。研究对现有医学文献进行了全面分析,重点关注 STEMI-NSTEMI 模型的局限性。该研究还概述了一种针对急诊胸痛患者的新诊断方法。传统的 STEMI-NSTEMI 模式在诊断精确性和有效治疗方面存在不足,尤其是在识别急性冠状动脉闭塞方面。在大量临床研究和专家意见的支持下,OMI-NOMI 框架提供了一个解剖学和生理学上更准确的模型。它强调了对疑似 OMI 病例进行快速心电图评估和立即再灌注治疗的必要性,旨在改善患者的预后。OMI-NOMI 框架为未来的研究和临床应用提供了一条新途径。它主张更全面地了解急性冠状动脉综合征的内在机制,从而制定个性化的治疗方案。这种新方法有望进一步引发学术讨论和研究,尤其是在巴西心脏病学领域,目的是提高急性冠脉综合征患者的诊断准确性和治疗效果。
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