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European Heart Journal 2004 25(24):2177-2179; doi:10.1016/j.ehj.2004.10.002
Copyright © 2004 by the European Society of Cardiology.
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Editorial

To open or not to open: that remains the question

Verghese Mathew* and Bernard J. Gersh

Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Gonda 5S, Rm 209, 200 First Street SW, Rochester, MN 55905, USA

* Correspondence to: Dr. Verghese Mathew, Associate Professor of Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Gonda 5S, 200 First Street SW, Rochester, MN 55905, USA. Tel.: +1 507 538 1469; fax: +1 507 266 9142 (E-mail: mathew.verghese@mayo.edu).

The first 150 words of the full text of this article appear below.

This editorial refers to "DECOPI (DEsobstruction COronaire en Post-Infarctus): a randomized multi-centre trial of occluded artery angioplasty after acute myocardial infarction"{dagger}; by P.G. Steg et al. on page 2187

The benefit of prompt reperfusion for ST-segment elevation myocardial infarction (STEMI) using either mechanical or pharmacologic modalities has been convincingly demonstrated. Successful reperfusion salvages myocardium, reduces infarct size, improves left ventricular function (although not uniformly so), and subsequently leads to better survival. This benefit is critically time-dependent within the first three hours after symptom-onset, with sustained but lesser degrees of benefit in the 3–12 h window after symptom-onset.1,2 The benefit of reperfusion in the 12–24 h period after symptom-onset is less pronounced, but likely to be beneficial in patients with signs or symptoms of ongoing ischaemia,3 and likely holds true even after 24 h in such patients.

If all eligible patients with STEMI received prompt and durable reperfusion therapy, a debate . . . [Full Text of this Article]


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Related articles in EHJ:

DECOPI (DEsobstruction COronaire en Post-Infarctus): a randomized multi-centre trial of occluded artery angioplasty after acute myocardial infarction
Philippe Gabriel Steg, Christophe Thuaire, Dominique Himbert, Didier Carrié, Stéphane Champagne, Damien Coisne, Khalife Khalifé, Pierre Cazaux, Damien Logeart, Michel Slama, Christian Spaulding, Ariel Cohen, Ashok Tirouvanziam, Jean-Michel Montély, Rosa-Maria Rodriguez, Eric Garbarz, William Wijns, Isabelle Durand-Zaleski, Raphaël Porcher, Lionel Brucker, Sylvie Chevret, Claude Chastang, and on behalf of the DECOPI Investigators
EHJ 2004 25: 2187-2194. [Abstract] [FREE Full Text]  



This article has been cited by other articles:


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B. J. Gersh, G. W. Stone, H. D. White, and D. R. Holmes Jr
Pharmacological Facilitation of Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: Is the Slope of the Curve the Shape of the Future?
JAMA, February 23, 2005; 293(8): 979 - 986.
[Abstract] [Full Text] [PDF]