THE MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS PRESENTING WITH ST-SEGMENT ELEVATION (STEMI)

TERM

DEFINITION

First medical contact (FMC)

Time of EMS arrival at scene (prehospital) or hospital registration (walk-in)

Time of STEMI diagnosis

Time of performance and interpretation of first ECG diagnostic of STEMI

First device deployment

Deployment of first PCI device (balloon or first stent)

Door in Door out (DIDO)

Time between registration of patient at non PCI capable hospital and patient leaving non-PCI capable hospital via EMS

Interfacility transport time

Time on the road between leaving non-PCI capable hospital and arrival at PCI capable hospital

Primary percutaneous coronary intervention (PPCI)

Mechanical reperfusion techniques aimed at restoring flow to the culprit vessel in acute STEMI. May include balloon angioplasty, coronary stenting or thrombectomy

Pharmacoinvasive strategy

A reperfusion strategy utilizing adjunctive PCI following initial pharmacological reperfusion with fibrinolysis. Consists of 1. routine immediate transfer to PCI centres after fibrinolysis, 2. immediate PCI for patients with failed fibrinolysis, and 3. routine angiography +/- PCI within 24 hours after successful fibrinolysis

Facilitated PCI

A reperfusion strategy where adjuvant therapies such as fibrinolysis or glycoprotein IIb/IIIa inhibitors are administered while in transit to immediate diagnostic angiography with the intent to perform immediate PPCI