Treatment and Care of Patients with ST-Segment Elevation Myocardial Infarction. What Challenges Remain after Three Decades of Primary Percutaneous Coronary Intervention?

Vittorio Zuccarelli; Stefano Andreaggi; Jason L Walsh; Rafail A. Kotronias; Chu Miao; Jonathan Vibhishanan; Adrian P. Banning; Giovanni Luigi De Maria

doi:10.20944/preprints202404.1481.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 22 April 2024 / Approved: 23 April 2024 / Online: 23 April 2024 (11:58:09 CEST)

Primary percutaneous coronary intervention (pPCI) has revolutionized the prognosis of ST-segment ele-vation myocardial infarction (STEMI) and is the gold standard treatment. As a result of its success, the number of pPCI centres has expanded worldwide. Despite decades of advancements, clinical outcomes in STEMI patients have plateaued. Out-of-hospital car-diac arrest and cardiogenic shock remain a major cause of high in-hospital mortality, whilst the growing burden of heart failure in long-term STEMI survivors presents a growing problem. Many elements aiming to optimize STEMI treatment are still subject to debate or lack sufficient evidence. This review provides an overview of the most contentious current issues in pPCI in STEMI patients, with an emphasis on unresolved questions and persistent challenges.

ST-elevation myocardial infarction; Primary Percutaneous Coronary Intervention; Coronary no-reflow

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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Treatment and Care of Patients with ST-Segment Elevation Myocardial Infarction. What Challenges Remain after Three Decades of Primary Percutaneous Coronary Intervention?

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