TREATMENTS IN AMI
Beneficial
Angiotensin converting enzyme inhibitors . .11
Aspirin . . . . . . . . . . . . . . . . . . . . . . . . . .4
Beta-blockers . . . . . . . . . . . . . . . . . . . .10
Primary percutaneous transluminal coronary
angioplasty versus thrombolysis (performed
in specialist centres) . . . . . . . . . . . . . .13
Thrombolysis. . . . . . . . . . . . . . . . . . . . . .4
Likely to be beneficial
Adding low molecular weight heparin
(enoxaparin) to thrombolytics (reduces
acute myocardial infarction rates) . . . . . .7
Nitrates (in the absence of thrombolysis). .12
Trade off between benefits and harms
Glycoprotein IIb/IIIa inhibitors . . . . . . . . . . .8
Unlikely to be beneficial
Adding unfractionated heparin to
thrombolytics. . . . . . . . . . . . . . . . . . . .7
Nitrates (in addition to thrombolysis). . . . .12
Likely to be ineffective or harmful
Calcium channel blockers . . . . . . . . . . . .12
CARDIOGENIC SHOCK AFTER AMI
Beneficial
Early invasive cardiac revascularisation . . .14
Unknown effectiveness
Early cardiac surgery . . . . . . . . . . . . . . .17
Intra-aortic balloon counterpulsation . . . . .16
Positive inotropes . . . . . . . . . . . . . . . . .15
Pulmonary artery catheterisation . . . . . . .16
Thrombolysis. . . . . . . . . . . . . . . . . . . . .15
Vasodilators . . . . . . . . . . . . . . . . . . . . .15
Ventricular assistance devices and cardiac
transplantation. . . . . . . . . . . . . . . . . .16