STEMI treatment

Oxygen, Cardiac monitoring/Defibrillator (CCU), Venflon left superior arm

  • Aspirin 500mg iv bolus
  • Oxygène si Sat = 2 < 90%
  • Prasugrel (Efient) 60 mg (6 cps of 10mg) orally in bolus, Ticagrelor (Brilique) 180 mg or Clopidogrel (Plavix) 600 mg (8 cps de 75mg or 2 cps of 300mg)]
  • Héparine (Liquémine) 5000-7500 UI iv bolus or Enoxaparine (Clexane) 30mg iv + completed to 1.0mg/kg PC sc) (note time !)
  • Morphine and nitrates if needed
  • Based on clinical evaluation: ß-Blockers (ex. Lopresor 5mg iv slow, 3x in 15 minutes) CAVE: Inferior infarction
  • Transfer patient for coronarography and percutaneous inervention (PCI).

Note for thienopyridines:

Clopidogrel (Plavix) or Ticagrelor (Brilique) if high risk of hemorhage (age > 75, weight < 60kg, renal failure with CrCl < 30ml/min, Status post CVA; or Mehran score > 25 pts)

Prasugrel (Efient) or Ticagrelor (Brilique) for the other patients.