New Heart Attack Treatment Guidelines Stress Coordination

  • Recommendations on use of a powerful new clot-dissolving drug, prasugrel (Effient), as an alternative to clopidogrel (Plavix), commonly prescribed after PCI. The greater ability of the new drug to dissolve clots does carry an added danger of excessive bleeding.
  • Use of a wire threaded into the coronary artery to gauge whether build-up of plaque deposits are great enough to warrant PCI.
  • Use of aspiration thrombectomy, in which the clot causing a heart attack is sucked out before a stent is implanted.
  • Recommendations on use of blood thinners and clot-dissolvers before, during or after PCI.
  • Recommendations on the types of X-ray dye used to view the heart arteries during PCI in patients with chronic kidney disease.

"But the big recommendation is that we need to improve the system of how patients get into one hospital when they are having a heart attack and then get into another hospital, if necessary," Smith said.

The guidelines will be published in the Dec. 1 issues of the Journal of the American College of Cardiology and Circulation, and the Nov. 18 issue of Catheterization and Cardiovascular Interventions.

More information

Heart attacks and their treatment are explained by the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Sidney C. Smith Jr., M.D., professor, medicine, University of North Carolina, Chapel Hill; Spencer B. King III, M.D., president, St. Joseph's Heart and Vascular Institute, Atlanta; Dec. 1, 2009, Journal of the American College of Cardiology; Dec. 1, 2009, Circulation; Nov. 18, 2009, Catheterization and Cardiovascular Interventions

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