Reperfusing Myocardium

• STEMI - main ways of re-perfusing the myocardium - use of thrombolytics:

  • best results achieved when a patient receives this therapy within 30 minutes of arrival at hospital – a “door to needle time target of 30 minutes"
  • Use of these clot busting drugs has largely been superseded by the use of PPCI, although in specific circumstances may still be occasionally used
• STEMI - main ways of re-perfusing the myocardium - PPCI:

  • patient outcomes are better using PPCI instead of thrombolytics
  • so PCCI as a procedure has replaced thrombolytics and become standard practice
  • So, door to needle targets have become “door-to-balloon” targets
  • This being a time measurement where the interval starts with the patient's arrival in the emergency department (or ambulance) and ends when a catheter guidewire crosses the culprit lesion in the cardiac catheter lab
  • International guidelines (including the UK) recommend a door-to-balloon interval of no more than 90 minutes