STEMI versus acute occlusive myocardial infarction: Which term should we use?

Title : STEMI versus acute occlusive myocardial infarction: Which term should we use?

Abstract:

The original trials assessing the effects of thrombolytic therapy versus placebo included patients with compatible symptoms and were not restricted to patients with ST elevation. However, a meta-analysis that was published in Lancet in 1996 suggested that thrombolytic therapy reduces mortality in patients with ST elevation, but not in patients with ST depression. Following this manuscript, the term STEMI has been used and the guidelines addressed patients with acute coronary syndromes with ST elevation and non-ST elevation separately. However, it became apparent that some patients with chest pain have ST elevation without having an acute occlusion of an epicardial artery, and there are patients with acute occlusion of a coronary artery that do not have ST elevation above the recommended threshold.  There are current attempts to refine our criteria to identify acute occlusion myocardial infarction independent of ST elevation. However, there is no evidence that acute reperfusion therapy affects outcomes in patients with acute coronary syndromes without ST elevation. The most recent European and American guidelines combine now STEMI and Non ST elevation acute coronary syndromes in one document.

Biography:

Yochai Birnbaum is currently working as a Professor of Medicine and the John S. Dunn Chair in Cardiology Research and Education at the Section of Cardiology at Baylor College of Medicine. He has completed his graduation from Hadassah Medical School at the Hebrew University, Jerusalem, Israel. He has completed his Residency in Internal Medicine at Kaplan Medical Center, Rehovot, Israel and his Cardiology Fellowship at Rabin Medical Center, Petah-Tiqva, Israel. He has also completed a Research Fellowship in Cardiology at Good Samaritan Hospital and the University of Southern California, Los Angeles, California and Research Fellowship in Echocardiography at Cedars-Sinai Medical Center, Los Angeles, California.