Percutaneous coronary intervention in acute myocardial infarction: from procedural considerations to long term outcomes

In patients presenting with a ST-segment elevated myocardial infarction (STEMI) reperfusion therapy should be initiated without delay. Patients are immediately transported to the catheterization laboratory to start primary percutaneous coronary intervention (PCI). Primary PCI is directed at removal of the occlusive thrombus and restoration of epicardial flow using implantation of a coronary stent. Nowadays, more than ninety-five percent of the admitted STEMI patients, not presenting with shock, survive the initial phase of myocardial infarction. This thesis addresses the possible complications that survivors of STEMI are faced with, ranging from radiation exposure, bleeding and thrombo-embolic events to ventricular arrhythmias and adverse left ventricular (LV) remodeling. In the last part of the thesis studies are presented that investigate the effects of intracoronary BMMC therapy as an adjunctive therapy to improve STEMI outcomes.