Achieving the earliest possible reperfusion in patients with acute coronary syndrome: a current overview

Takahiro Nakashima,Yoshio Tahara

doi:10.1186/s40560-018-0285-9

Abstract

Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. Appropriate management of ACS will lead to a lower incidence of cardiac arrest. Percutaneous coronary intervention (PCI) is the first-line treatment for patients with ACS. PCI techniques have become established. Thus, the establishment of a system of health care in the prehospital and emergency department settings is needed to reduce mortality in patients with ACS. In this review, evidence on how to achieve earlier diagnosis, therapeutic intervention, and decision to reperfuse with a focus on the prehospital and emergency department settings is systematically summarized.The purpose of this review is to generate current, evidence-based consensus on scientific and treatment recommendations for health care providers who are the initial points of contact for patients with signs and symptoms suggestive of ACS.

Highlights

Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide
The purpose of this review is to generate current, evidence-based consensus on scientific and treatment recommendations for health care providers who are the initial point of contact for patients with signs and symptoms suggestive of ACS based on the 2015 Japan Resuscitation Council (JRC) guidelines
These studies suggest that adenine diphosphate (ADP) receptor antagonists can be given to patients with suspected ST-elevation myocardial infarction (STEMI) and planned primary Percutaneous coronary intervention (PCI) in either the prehospital or the in-hospital setting

Summary

Background

Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. For patients with no ST elevation but non-STEMI (NSTEMI) or high-risk unstable angina is suspected, the emergency physician and cardiologist should work together on cardiac care unit admission. These patients have a high rate of adverse cardiac events (death, nonfatal myocardial infarction, and urgent revascularization). Signs and symptoms may be useful in combination with other important information such as biomarkers, risk factors, ECG, and other diagnostic test results, in triaging and making some treatment and investigational decisions for ACS in the out-of-hospital and ED settings.

14 ST-segment

Conclusion

Findings

Funding None