Primary PCI and Treatment of Reperfusion Injury in Acute Myocardial Infarction

Acute myocardial infarction (AMI) is responsible for the majority of (sudden) deaths and significant morbidity, thereby causing a major burden on health care. The prognosis of patients after an AMI is mainly determined by the size of the infarct, which is dependent of the area at risk (determined by localization of coronary occlusion), the duration of ischaemia, the severity of ischaemia (which is dependent on the degree of collateral flow and residual antegrade flow), and the mode of reperfusion.1 Any (ST-segment elevation) AMI should be reperfused as fast as possible (“time is muscle”), with primary percutaneous coronary intervention currently being considered as the optimal approach to the reperfusion therapy of myocardial infarction with ST-segment elevation.2 New insights into the pathophysiology, diagnosis and treatment strategies are generated striving to further improve treatment of patients with an AMI.