MYOCARDIAL INFARCTION: EARLY DIAGNOSIS AND MODERN REPERFUSION THERAPY
Keywords:
Myocardial Infarction, Early Diagnosis, High-Sensitivity Troponin, Electrocardiography, Reperfusion Therapy, Primary Percutaneous Coronary Intervention, Fibrinolysis, Ischemic Time, STEMI Networks.Abstract
Myocardial infarction (MI) remains a leading global cause of mortality and disability. The prognosis critically depends on the speed and accuracy of diagnosis and the prompt restoration of coronary blood flow. This article reviews contemporary strategies for the early diagnosis of MI, focusing on high-sensitivity cardiac troponin (hs-cTn) assays and point-of-care testing, alongside the pivotal role of electrocardiography (ECG). It then provides a detailed analysis of modern reperfusion therapy paradigms, primarily comparing primary percutaneous coronary intervention (PPCI) and pharmacological fibrinolysis. The discussion emphasizes the "time-dependent" nature of myocardial salvage, the central role of organized systems of care (e.g., STEMI networks), and evolving approaches for non-ST-elevation MI (NSTEMI). While PPCI is the preferred gold-standard when available within specific timeframes, facilitated and pharmaco-invasive strategies are crucial in settings with limited access to catheterization labs. Future directions, including artificial intelligence in ECG interpretation and novel antithrombotic agents, are also explored. This synthesis aims to provide a evidence-based overview for optimizing patient outcomes through rapid diagnosis and tailored reperfusion.
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