E3. STEMI Flashcards
T or F: The treatment options for STEMI include medical management, immediate cardiac catheterization, and fibrinolytic administration.
F: Medical Management should not be used in STEMI.
What are our primary treatment options for ACUTE STEMI?
- Immediate Cardiac Catheterization (Stent/Balloon Angioplasty)
- Fibrinolytic Administration
T or F: Fibrinolytics are only used in NSTEMI.
False. Fibrinolytics are only used in STEMI.
Should we use OSNAAP in STEMI?
Yes
Is OSNAAP exactly the same in STEMI as it is in NSTEMI?
No, the P2Y12i use is different.
When should fibrinolytic therapy be used in STEMI?
When the balloon to door time is >90 minutes.
What are the non-specific fibrinolytic therapies.
- Alteplase
- Reteplase
What are the specific (clot bound) fibrinolytic therapies?
- Tenecteplase
How does fibrinolytic therapy work?
It activates plasmin causing degradation of fibrin clots.
What is a major risk of fibrinolytic therapy?
Increased Bleeding risk.
Especially with aspirin, P2Y12i, or anticoagulant.
If fibrinolytic therapy is used in STEMI, what P2Y12i needs to be used.
Clopidogrel because it has a lower antiplatelet potency, and therefore lower bleeding risk.
In STEMI, what are the preferred P2Y12 inhibitors?
- Ticagrelor
- Prasugrel (after coronary visualization)
Clopidogrel if fibrinolytic therapy was used**
What is the loading dose of clopidogrel for STEMI if fibrinolytic therapy was not used?
600 mg
What is the loading dose of clopidogrel in STEMI if fibrinolytic therapy was used and the patient is under 75?
300 mg
What is the loading dose of clopidogrel in STEMI if fibrinolytic therapy was used and the patient is over 75?
75 mg
