Primary percutaneous coronary intervention vs fibrinolysis
It has been commonly observed that the periphery health facilities normally delay in transferring patients despite their need for reperfusion (Eric Et al, 2014). Most parts of the United States of America have medical medical institutions which have not developed reperfusion guidelines (for both fibrinolysis and the primary percutaneous coronary intervention) aimed at minimizing delays in reperfusion. Therefore treatment modalities and strategies have been solely left for the discretion of the attending physician. A study done revealed that very few patients were able to reach their destined health facilities on time for treatment, some of the challenges to this include; the un-availability of air transport and the prevailing bad weather conditions. The study also recommended the use of a standardized protocol for treatment of patient with acute coronary syndrome.
The performance measures which have been instituted to prevent and reduce the need for treatment of a new or a recurrent episode of an cute coronary syndrome includes ; administration of aspirin therapy within the first twenty-four hours of an acute myocardial infarction event, the patient should also be given an aspirin therapy on discharge, he or she should also be counseled on cessation of smoking, administration of angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) therapy on discharge. The patient should also be prescribed a beta blocker and a lipid lowering therapy on discharge (Hira et al, 2016). It was demonstrated that the hospital mortality in patients with S-T segment Elevation Myocardial Ischemia, who received fibrinolysis therapy remained constant, however the other cohort who received primary percutaneous coronary intervention (PPCI) recorded an improvement and reduced mortality rate.
This study highlighted the importance of improving on the use of fibrinolysis therapy among the eligible patients who presented with S-T segment Elevation Myocardial Ischemia (Hira et al, 2016). A study done to the compare the effectiveness of primary percutaneous coronary intervention (PPCI) and fibrinolysis revealed that, advancing in age is associated with poor-prognosis among the patients who presents with an acute S-T segment Elevation Myocardial Ischemia. Overall decline in mortality was exhibited. However, there were no conclusive long-term benefits in mortality and re-infarction in observational studies (Huynh, 2009). A study done in one of the hospitals in the United States concluded that, for those patients presenting with ST-segment elevation myocardial infarction who received fibrinolysis, almost 38. 2% achieved a good prognosis in less than or equal to thirty minutes.
However, the use of fibrinolysis has drastically reduced over time since 2003. C. Fibrinolytic Therapy Versus Primary Percutaneous Coronary Interventions for ST-Segment Elevation Myocardial Infarction in Kentucky: Time to Establish Systems of Care? Division of Cardiovascular Medicine, Gill Heart Institute, and the College of Public Health, University of Kentucky, Lexington. doi:10. 1097/SMJ. 0b013e31829ba880. S…Jneid,H, (2016). Temporal trends in care and outcomes of patients receiving fibrinolytic therapy compared to primary percutaneous coronary intervention: insights from the get with the guidelines coronary artery disease(gate-cad) registry. Journal of the American heart association: cardiovascular and cerebrovascular disease,5(10), e004113. Doi. org/10. Circulation 119 (24), 3101-3109. Karha, J. , & Topol, E, J. To Primary Percutaneous Coronary Intervention vs. Fibrinolytic Therapy for ST Elevation Myocardial Ischemia In The Elderly.
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