Open AccessCoronary thrombus in patients undergoing primary PCI for STEMI: Prognostic significance and management
Author(s) -
Silvia Lo Vecchio
Publication year - 2014
Publication title -
world journal of cardiology
Language(s) - English
Resource type - Journals
ISSN - 1949-8462
DOI - 10.4330/wjc.v6.i6.381
Subject(s) - medicine , cardiology , antithrombotic , percutaneous coronary intervention , conventional pci , myocardial infarction , thrombus , perfusion
Acute ST-elevation myocardial infarction (STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator, which is mostly proportional to their size and composition. Particularly, intracoronary thrombi impair both epicardial blood flow and myocardial perfusion, by occluding major coronary arteries and causing distal embolization, respectively. Thus, although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting, the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients, by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used in the setting of STEMI to manage thrombotic lesions.