Evaluation and Outcome of Patients of Stemi with Acute Total Occlution of Coronary Artery in The Setting of Primary PCI, Pharmaco Invasive PCI and Delayed PCI

Abstract

At the most severe end of the spectrum of acute coronary syndromes is ST-Segment Elevation Myocardial Infarction (STEMI), which usually occurs when a fibrin-rich thrombus completely occludes an epicardial coronary artery. The diagnosis of STEMI is based on clinical characteristics and persistent ST-segment elevation as demonstrated by 12-lead electrocardiography. Patients with STEMI should undergo rapid assessment for reperfusion therapy, and a reperfusion strategy should be implemented promptly after the patient’s contact with the health care system. Two methods are currently available for establishing timely coronary reperfusion: primary percutaneous coronary intervention and fibrinolytic therapy [1]. Percutaneous coronary intervention is the preferred method but is not always available. ST-segment elevation myocardial infarction (STEMI) is characterized by total occlusion of the infarct-related artery in contrast to Unstable Angina or Non-ST elevate d Myocardial Infarction (UA/NSTEMI) [2]. Evidence from several randomized clinical trials during the past two decades has established the importance of the open artery theory, which states that prompt and complete restoration of flow in the occluded artery decreases infarct size, preserves Left Ventricular (LV) function, and improves survival rates. The role of Percutaneous Coronary Interventions (PCIs) in the early hours of an STEMI can be divided into primary PCI, Pharmacoinvasive PCI, and Delayed PCI [3].