ST Elevation Myocardial Infarction

A clinical syndrome defined by MYOCARDIAL ISCHEMIA symptoms; persistent elevation in the ST segments of the ELECTROCARDIOGRAM; and release of BIOMARKERS of myocardial NECROSIS (e.g., elevated TROPONIN levels). ST segment elevation in the ECG is often used in determining the treatment protocol (see also NON-ST ELEVATION MYOCARDIAL INFARCTION).

Also Known As:

Networked: 12701 relevant articles (900 outcomes, 3487 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	ST Elevation Myocardial Infarction
2.	Myocardial Infarction
3.	Thrombosis (Thrombus)
4.	Infarction (Infarctions)
5.	Hemorrhage

Experts

1.	Stone, Gregg W: 208 articles (01/2022 - 03/2004)
2.	Mehran, Roxana: 161 articles (01/2022 - 03/2005)
3.	Granger, Christopher B: 134 articles (05/2022 - 08/2002)
4.	Gibson, C Michael: 131 articles (06/2022 - 03/2002)
5.	Dudek, Dariusz: 129 articles (08/2021 - 01/2004)
6.	Montalescot, Gilles: 113 articles (10/2022 - 01/2003)
7.	Armstrong, Paul W: 110 articles (05/2022 - 01/2003)
8.	Jeong, Myung Ho: 108 articles (06/2022 - 08/2007)
9.	Zeymer, Uwe: 99 articles (06/2022 - 04/2003)
10.	Roe, Matthew T: 97 articles (03/2021 - 09/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to ST Elevation Myocardial Infarction:

1.	Clopidogrel (Plavix)FDA Link 01/01/2010 - "We suggest that Clopidogrel is effective in prevention of LVEF reduction in patients with STEMI." 06/01/2007 - "Treatment of these STEMI patients with clopidogrel appeared to be cost-effective in all 3 European countries studied. " 07/01/2012 - "Biological efficacy of a 600 mg loading dose of clopidogrel in ST-elevation myocardial infarction." 12/18/2006 - "Clopidogrel has also been shown to improve angiographic and clinical outcomes in patients with STEMI who are undergoing thrombolysis or being treated medically. " 04/01/2017 - "We searched PubMed, Embase, Cochrane Library, CNKI, VIP, and WanFang Data to identify randomized controlled trials comparing novel oral P2Y12 receptor inhibitors with clopidogrel in patients with STEMI undergoing PCI until February 2016. "
2.	TicagrelorIBA 01/01/2020 - " Use of GPIs in addition to ticagrelor in STEMI patients was not associated with an improvement in 30-day ischemic outcome. " 01/01/2023 - "This trial included 374 STEMI patients with a low platelet response after ticagrelor LD. " 05/01/2020 - "Safety and Cumulative Incidence of Major Cardiovascular Events with Ticagrelor in Taiwanese Patients with Non-ST-Segment Elevation Myocardial Infarction: A 12-Month, Prospective, Phase IV, Multicenter, Single-Arm Study." 01/01/2020 - "The ATLANTIC study compared prehospital versus inhospital treatment with ticagrelor in patients with acute STEMI. " 04/01/2019 - "ATLANTIC was an international, multicenter, randomized study of treatment in the acute ambulance/hospital setting where STEMI patients received ticagrelor 180 mg ± morphine. "
3.	Abciximab (ReoPro)FDA Link 06/01/2012 - "The present updated meta-analysis showed that IC administration of abciximab is associated with significant benefits in myocardial perfusion, but not in clinical outcome at short-term follow-up as compared to IV abciximab administration, without any excess of major bleedings in STEMI patients undergoing primary PCI. " 03/01/2012 - "IC abciximab in the setting of pPCI for ST-segment elevation myocardial infarction may be beneficial for patients with higher risk profiles." 01/01/2011 - "In pPCI-treated STEMI patients treated with abciximab, IC bolus administration resulted in a significant reduction in mortality, TVR and MI compared to IV bolus administration." 05/05/2009 - "Abciximab has been shown to provide significant benefits in PPCI for STEMI. " 04/13/2005 - "This meta-analysis shows that, when compared with the control group, adjunctive abciximab for STEMI is associated with a significant reduction in 30-day and long-term mortality in patients treated with primary angioplasty but not in those receiving fibrinolysis. "
4.	omega-Chloroacetophenone (Mace)IBA 08/01/2020 - "The findings of this meta-analysis suggest that in patients with STEMI and MVD, complete revascularization is superior to culprit-only PCI in reducing the risk of MACE outcomes, including cardiovascular mortality, without increasing the risk of adverse safety outcomes." 01/01/2016 - "This study shows that among STEMI patients undergoing primary PCI EES, as compared to SES, is associated with significant reduction in MACE and ST at long-term follow-up." 01/01/2022 - "Compared with AT, intracoronary-administered thrombolytics significantly improved myocardial perfusion and MACE in STEMI patients." 04/01/2021 - "Low-risk STEMI patients stratified by Zwolle risk score, who were treated successfully with PPCI, experienced low 30-day MACE and mortality rates, indicating that early discharge may be safe in these patients. " 01/01/2021 - "In contrast to the culprit-only approach, MVR in patients with STEMI is associated with a significant reduction in MACE, angina and need for revascularization."
5.	Heparin (Liquaemin)FDA LinkGeneric 03/10/2009 - "Although weight-based nomograms have improved the efficacy and safety of dosing unfractionated heparin in ST-segment elevation myocardial infarction, achieving therapeutic anticoagulation in practice remains challenging. " 05/01/2022 - "Although heparin administration in patients with STEMI undergoing PPCI is safe and effective, the effect appears not to be time-dependent." 10/01/2020 - "Pre-hospital Administration of Unfractionated Heparin in STEMI Is Associated With Improved Long Term Survival. " 01/01/2020 - "Prehospital Administration of Unfractionated Heparin in ST-Segment Elevation Myocardial Infarction Is Associated With Improved Long-Term Survival." 12/18/2021 - "In this multicentre, propensity-score matched study, the use of pre-hospital heparin by paramedics was safe and is associated with fewer occluded IRAs in patients presenting with STEMI."
6.	Prasugrel HydrochlorideFDA Link 06/01/2013 - "Prasugrel is indicated in patients with ACS undergoing PCI and was most effective in diabetics and in patients with STEMI. " 02/01/2014 - "Our study demonstrates that prasugrel could produce a significantly greater peri-procedural as well as in-hospital IPA compared with TAP in patients with STEMI undergoing primary PCI." 07/01/2018 - "In STEMI patients, a significant reduction in PRU was observed at 4 h after prasugrel loading. " 01/01/2018 - "In this contemporary study of patients with STEMI, early prasugrel cessation was not uncommon and primarily involved change to another P2Y12-inhibitor. " 03/01/2012 - "Our study shows that prasugrel administration leads to a suboptimal IPA for at least 2 h in STEMI patients. "
7.	Glycoproteins (Glycoprotein)IBA 04/01/2012 - "Safety and efficacy of rescue angioplasty for ST-elevation myocardial infarction with high utilization rates of glycoprotein IIb/IIIa inhibitors." 08/10/2004 - "We hypothesized that improved epicardial patency, myocardial perfusion, and ST-segment resolution would be associated with higher levels of platelet receptor occupancy (RO) by a glycoprotein IIb/IIIa antagonist in ST-elevation MI (STEMI). " 01/01/2006 - "Evidence from clinical trials shows that addition of glycoprotein IIb/IIIa inhibition to PCI for treatment of STEMI has substantially lowered the incidence of recurrent ischemic events and improved early survival. " 01/01/2022 - "Efficacy and safety of glycoprotein IIb/IIIa inhibitors in addition to P2Y12 inhibitors in ST-segment elevation myocardial infarction: A subanalysis of the POPular Genetics trial." 07/15/2014 - "Previous studies investigating prehospital use of glycoprotein IIb/IIIa inhibitors (GPIs) in patients with ST-segment elevation myocardial infarction reached conflicting conclusions. "
8.	Tirofiban (Aggrastat)FDA Link 07/01/2012 - "We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. " 11/01/2007 - "The On-TIME 2 trial evaluates whether pre-hospital initiation of high-dose bolus tirofiban is effective for patients with STEMI who are candidates to undergo PCI. " 01/01/2022 - "Tirofiban injection after emergency PCI is a beneficial treatment regime for patients with STEMI. " 07/01/2011 - "On the basis of the high-dose regimen, tirofiban may be considered useful in the management of patients with ST-elevation myocardial infarction who undergo primary angioplasty." 01/01/2009 - "On the basis of the demonstrated benefits of the high-dose bolus regimen, tirofiban may be considered useful in the management of patients with STEMI."
9.	Platelet Membrane Glycoprotein IIbIBA 10/01/2009 - "This meta-analysis shows that pharmacological facilitation with early administration of Gp IIb-IIIa inhibitors in STEMI patients with diabetes undergoing primary angioplasty, is associated with significant benefits in terms of preprocedural and postprocedural TIMI flow, improved myocardial perfusion, without significant benefits in mortality." 04/01/2001 - "Furthermore, recent clinical trials with a small number of patients suggest that GP IIb/IIIa inhibitors in combination with low-dose fibrinolytics are safe and effective for the treatment of ST segment elevation myocardial infarction. " 01/01/2018 - "DES use, radial access and GP IIb/IIIa use in patients with ST-segment elevation myocardial infarction were associated with improved all-cause mortality in our population. " 07/01/2012 - "GP IIb/IIIa inhibitors for STEMI: still the gold standard or an old survivor?" 01/01/2008 - "Early GP IIb/IIIa inhibition in patients undergoing PCI for STEMI results in early reperfusion and can result in improved clinical outcomes. "
10.	bivalirudin (Angiomax)FDA Link 08/01/2017 - "Trials were included if study patients were undergoing primary PCI for acute ST-segment elevation myocardial infarction and were randomly assigned to bivalirudin or UFH treatment. " 12/12/2016 - "Several clinical trials have compared the safety and effectiveness of bivalirudin versus UFH during PCI for STEMI, but results have been conflicting. " 01/01/2015 - "A meta-analysis of randomised trials comparing bivalirudin and UFH in patients with ACS receiving PCI, with separate analyses in STEMI and NSTE-ACS groups. " 10/01/2012 - "Major insights from the HORIZONS-AMI trial regarding the impact of bivalirudin on both hemorrhagic and ischemic outcomes in STEMI patients are discussed." 01/01/2012 - "Based on the results of the trial, the American College of Cardiology/American Heart Association and European Society of Cardiology guidelines have incorporated recommendations for bivalirudin use in the setting of STEMI. "

Therapies and Procedures

1.	Percutaneous Coronary Intervention 12/30/2016 - "CONCLUSIONS Although the most appropriate timing to treat simultaneous multiple culprit lesions has yet to be definitively defined, multi-vessel percutaneous coronary intervention in the setting of a STEMI with multiple culprit lesions is feasible with good outcome as shown by our index case." 01/01/2021 - "Background In ST-segment-elevation myocardial infarction, angiography-based complete revascularization is superior to culprit-lesion-only percutaneous coronary intervention. " 11/01/2010 - "Significant reductions in time to first ECG in the emergency department and D2B were seen in group 2 compared with group 1. Important improvement in the process of acute STEMI patient care was accomplished in the rural percutaneous coronary intervention center setting by implementing evidence-based strategies." 11/01/2010 - "The REVEAL trial will evaluate the safety and efficacy of the highest tolerated single dose of epoetin α in patients who have undergone successful rescue or primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction." 04/01/2009 - "The study included 39 patients with first anterior STEMI treated successfully with primary percutaneous coronary intervention. "
2.	Therapeutics 11/16/2016 - "Furthermore, we performed post hoc analysis for the subsets of patients and the results revealed that patients with non-ST-segment elevation myocardial infarction benefited the most from β-blocker therapy at discharge (HR, 0.04; 95% CI, 0.00-0.27 [P=0.001]), and the use of <50% of target dose was significantly associated with better outcome compared with no β-blocker use, rather than ≥50% of target dose. " 02/01/2013 - "A large, adequately powered randomized trial is urgently needed to determine whether routine staged PCI plus optimal medical therapy is superior to optimal medical therapy alone for significant non-culprit coronary artery lesions in patients who have undergone successful primary PCI for STEMI." 09/01/2019 - "There is a huge potential of improvement in ST-elevation myocardial infarction care in terms of increasing community awareness, prompt reperfusion therapy and usage of optimal medical therapy." 01/01/2015 - "And our study was designed to assess the efficacy of 72-hour IV infusion of rh-BNP therapy in STEMI patients with or without successful primary PCI, in preventing adverse LV remodeling and preserving LV function. " 06/21/2021 - "When PCI is used for STEMI, only DCB therapy is safe and effective, and has shown good clinical effects during a one-year follow-up period."
3.	Stents 10/01/2012 - "Primary PCI with stent implantation as soon as possible is the best treatment strategy for patients with STEMI. " 01/01/2021 - "In this exploratory, hypothesis-generating study, postdilatation during primary-PCI for STEMI improved stent expansion, apposition and post-PCI FFR, without a significant effect on coronary microcirculation overall. " 04/08/2016 - "The strategy of forward and back aspiration to facilitate stent implantation and high-pressure post-dilatation during STEMI appears to be safe and effective. " 09/01/2014 - "While EES seem to be associated with better outcome when compared to PES, the main correlates of STEMI patients are the presence of diabetes and number of stents implanted, and not the type of stent used for intervention." 10/01/2015 - "The use of the MGuard Prime EPS stent is feasible and safe and could be also effective in achieving myocardial reperfusion in STEMI patients undergoing PPCI."
4.	Thrombolytic Therapy 08/01/2011 - "Mean/median of door to needle time (DTNT) and percentage of STEMI patients receiving thrombolytic therapy who achieved DTNT within 30 minutes were significantly improved, showing 73.24 +/- 54.78/65 vs. 46.05 +/- 33.88/30 minutes; p < 0.001 and 6% vs. 50.6%; p < 0.001 respectively. " 03/01/2006 - "PCI performed after combined fibrinolytic therapy in STEMI patients is associated with high efficacy and improvement in indices of epicardial perfusion and microcirculation. " 09/01/2019 - "Although primary percutaneous intervention (PCI) is first-line treatment in STEMI, fibrinolytic therapy (FT) is still widely used in many countries. " 10/01/2012 - "This classification is historically related to the use of thrombolytic therapy, which is effective in STEMI. " 01/30/2007 - "Rescue PCI is associated with improved clinical outcomes for STEMI patients after failed fibrinolytic therapy, but these benefits must be interpreted in the context of potential risks. "
5.	Drug-Eluting Stents 03/01/2014 - "In an unselected nationwide real-world cohort, an approach using immediate complete revascularization may be beneficial in STEMI patients with MVD regarding MACCE, specifically when drug-eluting stents are used, but not regarding mortality. " 01/01/2022 - "Corrigendum: Safety and efficacy of contemporary drug-eluting stents in patients with ST-segment elevation myocardial infarction and a high ischemic risk." 01/01/2022 - "Safety and Efficacy of Contemporary Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction and a High Ischemic Risk." 01/23/2016 - "Data for the safety and efficacy of new-generation drug-eluting stents at long-term follow-up, and specifically in patients with ST-segment elevation myocardial infarction, are scarce. " 05/01/2008 - "Safety and efficacy of drug-eluting stent for ST-segment elevation myocardial infarction in an unselected consecutive cohort."