Interventions in the Acute Phase of Myocardial Infarction

In the 1980's a primary focus for intense cardiovascular research is in the treatment of patients with acute myocardial infarction. Although the prevalence of this syndrome has been decreasing in the United States, still over 1.5 million patients develop myocardial infarction per year. There is about a 20% chance of a North American male developing myocardial in­ farction before the age of 65. The in-hospital mortality still remains at ap­ proximately 10070-15070 and advances in pharmacologic and device therapy have allowed for the intensification of research in the treatment of patients with acute myocardial infarction. The following manuscripts represent the collective efforts of academic in­ vestigators in the United States and abroad as well as members of the phar­ maceutical industry, and the Food and Drug Administration to address the issues involved in interventions in the acute phase of myocardial infarction. State-of-the-art papers addressing important topics are followed by discus­ sion sections which have allowed participants to express their own viewpoints leading to a consensus opinion. The first part of this Symposium addresses the models of experimental myocardial infarction followed by the important issue of how one defines myocardial infarction size. The latter is extremely important to be certain that endpoints of therapeutic or device interventions are objective and reproducible. A detailed description of the pharmacological interventions to reduce myocardial infarction size as well as newer devices to effect mechanical and electrical disorders provide an up-to-date summary of current opinion.

Contenu

Models to Study Experimental Infarction.- 1 Experimental Models and Endpoints for Evaluating Interventions in the Acute Phase of Myocardial Infarction - An Anatomic Approach.- 2 Models to Study Experimental Infarction - Pharmacologic.- 3 Pharmacokinetics of Anti-Arrhythmic Agents in Acute Myocardial Infarction.- Indices to Define Infarct Size.- 4 Limitations of Electrophysiologic Techniques in Defining Myocardial Infarct Size.- 5 Estimates of Injury after Infarction Evolving Spontaneously or in Response to Coronary Thrombolysis.- 6 Measurement of Myocardial Infarct Size Using Nuclear Cardiology Methods.- 7 Echocardiographic Approaches to the Evaluation of Acute Myocardial Infarction.- 8 Two Dimensional Echocardiography in Acute Myocardial Infarction: Clinical Applications.- 9 Panel on Indices to Define Infarct Size Moderator.- Pharmaceutical Interventions to Reduce Infarct Size.- 10 The Case for Prophylactic Lidocaine in Acute Myocardial Infarction.- 11 Infarct Size Reduction by Antiarrhythmic Prophylaxis - A Contrary View.- 12 Pharmaceutical Interventions to Reduce Infarct Size - Streptokinase.- 13 Streptokinase in Acute Myocardial Infarction.- 14 Vasodilators in Acute Myocardial Infarction.- 15 Panel on Pharmaceutical Interventions to Reduce Infarct Size Moderator.- 16 Early Intravenous Atenolol in Suspected Acute Myocardial Infarction: Final Report of a Randomized Clinical Trial.- 17 Calcium Channel Blockers and Limitation of Myocardial Infarction Size.- 18 Steroid Treatment of Acute Myocardial Infarction: Some Implications for Clinical Trials in General.- 19 Evaluation of Inotropic Therapy.- 20 Panel on Pharmaceutical Interventions to Reduce Infarct Size Moderator.- Devices to Limit Infarct Size.- 21 Transluminal Coronary Angioplasty.- 22 Devices to Limit Infarct Size: Ventricular Assist Devices.- 23 Internal Electrical Devices to Limit Infarct Size.- 24 Devices to Limit Infarct Size - FDA Evaluation.- 25 Panel on Devices to Limit Infarct Size.- Summary of Symposium on New Drugs and Devices.- Participant List.