Coronary artery disease is the leading cause of death in the United States and Europe. More than 500,000 Americans annually suffer an acute myocardial infarction with EKG changes of ST-segment elevation or new left-bundle branch block. ST-elevation myocardial infarction (STEMI) is a medical emergency, analogous to major trauma or aortic dissection, where even “minutes” of delay in initiating appropriate treatment significantly increases mortality.Two important principles guide our approach to myocardial reperfusion:
1. “Time is heart muscle”– Early reperfusion of the infarct related artery as quickly as possible within the first 12 hours of artery occlusion limits infarct size, increases myocardial salvage, preserves left ventricular function,and in turn improves patient survival.