Reddy K, Khaliq A, Henning RJ. Recent advances in the diagnosis and treatment of acute myocardial infarction. World J Cardiol 2015; 7(5): 243-276 [PMID: 26015857 DOI: 10.4330/wjc.v7.i5.243]
Corresponding Author of This Article
Robert J Henning, MD, Department of Medicine, James A Haley Veterans Administration Hospital and the University of South Florida College of Medicine, 13000 Bruce B Downs Blvd, Tampa, FL 33612, United States. robert.henning@va.gov
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. May 26, 2015; 7(5): 243-276 Published online May 26, 2015. doi: 10.4330/wjc.v7.i5.243
Recent advances in the diagnosis and treatment of acute myocardial infarction
Koushik Reddy, Asma Khaliq, Robert J Henning
Koushik Reddy, Asma Khaliq, Robert J Henning, Department of Medicine, James A Haley Veterans Administration Hospital and the University of South Florida College of Medicine, Tampa, FL 33612, United States
Author contributions: Reddy K, Khaliq A and Henning RJ contributed to the writing of this paper.
Supported by Research facilities at the James A Haley VA Hospital and, in part; Grants from the Florida King Biomedical Research Program, the Muscular Dystrophy Association, the Robert O Law Foundation and the Cornelius Foundation.
Conflict-of-interest: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Robert J Henning, MD, Department of Medicine, James A Haley Veterans Administration Hospital and the University of South Florida College of Medicine, 13000 Bruce B Downs Blvd, Tampa, FL 33612, United States. robert.henning@va.gov
Telephone: +1-813-9785873
Received: February 24, 2014 Peer-review started: February 26, 2014 First decision: March 26, 2014 Revised: February 14, 2015 Accepted: March 5, 2015 Article in press: March 9, 2015 Published online: May 26, 2015
Core Tip
Core tip: The Third Universal Definition of myocardial infarction (MI) combines clinical symptoms, cardiac biomarkers and electrocardiogram (ECG) changes. Small amounts of myocardial necrosis may occur with heart failure, renal failure, myocarditis, arrhythmias, pulmonary embolism or uneventful percutaneous or surgical coronary revascularization and should be termed myocardial injury. High sensitivity troponin assays increase the sensitivity but decrease the specificity of MI diagnosis. The ECG remains a cornerstone of MI diagnosis. Primary percutaneous coronary intervention in a timely manner is the primary treatment of patients with acute ST segment elevation MI. Antiplatelet agents (clopidogrel, prasugrel or ticagrelor), in addition to aspirin, reduce patient MI morbidity and mortality. The recent LateTime, Time, and Swiss Multicenter Trials of bone marrow stem cells in MI treatment did not demonstrate significant improvement in patient LV ejection fraction in comparison with placebo. In contrast, cardiac stem cells from the right atrial appendage or ventricular septum/apex in the SCIPIO and CADUCEUS Trials reduced patient MI size and increased viable myocardium. Studies with cardiac stem cells are continuing.
