Management of ST-segment elevation acute myocardial infarction: What has changed in the new European Society of Cardiology guideline?

Based on the new findings derived from the recent studies, the European Society of Cardiology has updated the guidelines for acute myocardial infarction in patients with ST-segment elevation. New guidelines have been released on November 2008, and compared to the 2003 guidelines, important new recommendations have been made regarding the acute and long term management of patients presenting with ST-segment elevation myocardial infarction. These new recommendations primarily focus on: the need for setting up networks of hospitals with different levels of technology using the same protocol and connected by an efficient ambulance service; the selection of primary percutaneous coronary intervention (PCI) vs. fibrinolytic therapy; the use of antithrombotic co-therapies with both primary PCI and fibrinolysis; timing of angiography in patients not undergoing to primary PCI; secondary prevention in long term management following the myocardial infarction.