ST-elevation myocardial infarction 2013

4 papers were presented reviewing treatment options for ST elevation myocardial infarction.
The first talk was a splendid presentation was by Bernard Gersh and included time from first symptom to pre-hospital, door to balloon times in treatment of STEMI. The conclusion was things were going pretty well once a patient was in a cath lab and that treatment times were within the guidelines. The issue still to be resolved is getting patients quickly to a cath lab.
Often, even when there are cath labs or hospitals are available, there is often delay. To reduce myocardial damage it might be that fibrinolytic treatment could be started by paramedics to get early reperfusion.
Stefan James gave some insights into the Swedish care system with the SwedeHeart data. Considering the size of the country and the sparse population in large areas of the country, outcomes for patients in Sweden tend to be as good. Deepak Bhatt considered the part adjunctive therapies can play in improving outcomes. Although TAPAS was an encouraging study, TASTE was neutral and the value of thrombus removal, particularly by aspiration, seemed useful. Much of the presentation summarized the work done with the newer anticoagulants and antiplatelet agents.
Rounding off the session Michael Marber discussed new approaches that might be taken. The focus was on reducing myocardial damage with drugs in trials such as DETO2X-AMI and PRESERVATION 1, but the role of cell therapy might ultimately be a potential treatment to reverse myocardial damage.