Abstract:

In this review, we will discuss new and revised concepts in the ESC (European Society of Cardiology) 2017 ST-segment elevation myocardial infarction (STEMI) guideline. The definition of STEMI has been expanded to increase the patient coverage. The concept of 'diagnosis to wire crossing' has been developed for the shortening of the duration of reperfusion while the importance of oxygen therapy and opioids are diminished in emergency treatment. The time to coronary angiography was reduced to 2-24 hours, and percutaneous coronary intervention (PCI) was not recommended after 48 hours in the absence of ischemia. While radial intervention and the use of drug-eluting stents are at the forefront, routine thrombus aspiration is no longer recommended. Complete revascularization is recommended before leaving the hospital. Bivalirudin is less recommended as it has increased stent thrombosis Enoxaparine is used as an alternative to heparin in PCI. The use of potent P2Y12 inhibitors seems superior to clopidogrel. Cangrelor has been used for the first time in patients not taking oral administration. The use of additional medications is recommended in patients with LDL> 70 mg / dL despite the use of the maximum dose of statin. It has been mentioned that while dual antiplatelet therapy is recommended for one year, it can be extended to 36 months. Criteria have been set for standardization of quality indicators.

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