Rupture of an atherosclerotic plaque in the coronary artery circulation is the usual initiating event in an acute coronary syndrome (ACS). Persistent thrombotic occlusion at the site of plaque rupture results in acute myocardial infarction (MI). This topic will review the evidence that antiplatelet therapy is beneficial in patients with an acute ST-elevation MI (STEMI), one of the three types of ACS, and will provide recommendations for its use. Information regarding antiplatelet agents in non-ST elevation ACS (unstable angina or non-ST elevation MI) and the role of anticoagulant therapy in STEMI are discussed separately. (See "Antiplatelet agents in acute non-ST elevation acute coronary syndromes" and "Anticoagulant therapy in acute ST elevation myocardial infarction".)
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Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction. www.acc.org/qualityandscience/clinical/statements.htm (Accessed on August 24, 2006).