Irish Medical Times
Monday 3 September 2012
New ESC guidelines in STEMI
Danielle Barron reporting from ESC in Munich
New guidelines for the effective treatment of patients presenting with ST segment elevation myocardial infarction (STEMI) were unveiled in new clinical practice guidelines published by the European Society of Cardiology (ESC) at their annual congress in Munich last week.
The new guidelines emphasis the importance of pre-hospital logistics of care and were presented on the first day of the congress.
The guidance now recommends that centres equipped to perform primary PCI should deliver care on a 24/7 basis and within 60 minutes of an initial call. This means that ambulance teams should be trained and able to identify patients with STEMI and administer initial therapy, including fibrinolysis if applicable.
“Prevention of delays is critical,” state the new guidelines, which add that every sixth man and seventh woman in Europe will die from myocardial infarction.
Also presented at the congress was a Swiss study that showed echocardiogram (ECG) to be a cost effective screening method for cardiac problems in young athletes.
The researchers assessed competitive athletes aged 14-35 years based on family and personal history, physical examination and resting ECG. The results showed that 6.3 percent of those screened required further examinations, 3.9 per cent because of abnormal ECGs. A previous unknown cardiac abnormality was established in two per cent of the athletes.
Furthermore, in 0.4 per cent, an abnormality potentially responsible for sudden cardiac death was identified – Wolff-Parkinson-White syndrome and long QT syndrome.
The researchers estimated the average cost per athlete at around €115 – even in Switzerland where the costs of medical services are high – they note.
Another study carried out in the Netherlands found that people who have a cardiac arrest during or shortly after exercise are three times more likely to survive than those whose arrest was not exercise related. The findings came from the Amsterdam Resuscitation Study.