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Rising to the challenge: transforming the treatment of ST-segment elevation myocardial infarction

Ghali WA, Donaldson CR, Knudtson ML, Lewis SJ, Maxwell CJ, Tu JV. CMAJ. 2003; 169(1):35-7.


The care of patients with ST-segment elevation myocardial infarction (STEMI) is continually evolving. In the early 1960s, typical care involved primarily bedrest with few, if any, interventions. This was followed by an era of closer observation in coronary care units but still little in the way of beneficial medical interventions apart from prompt cardioversion of lethal arrhythmias. More recently, typical care has evolved to incorporate acute treatment with ASA, heparins, β-blocking drugs, angiotensin-converting-enzyme inhibitors and thrombolytic agents. This evolution toward new, efficacious therapies has been accompanied by a decrease over time in the rate of death from myocardial infarction — a good news story.

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Keywords: Drugs (cardiovascular) Coronary disease/Myocardial infarction Health services research

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