What are the recommended strategies for the treatment and prevention of PCI?
Treatment and prevention strategies for PCI have included the use of the GP IIb/IIIa antagonist abciximab, vasodilators (nitroprusside, verapamil, adenosine), and inhibitors of various metabolic pathways (nicorandil, pexelizumab). Manual thrombus aspiration at the time of primary PCI has been shown to result in improved tissue perfusion and more complete results, although not all studies have shown positive results. In hemodynamically stable patients, PCI of a noninfarct artery with TIMI 3 flow at the time of primary PCI has been associated with worse clinical outcomes in several studies. Noninfarct artery PCI is not recommended in this context unless multiple complex lesions are seen on angiography and ECG localization of the infarct is present. Aspiration thrombectomy is a reasonable recommendation for patients undergoing primary PCI, as it has been shown to improve microvascular reperfusion and to decrease deaths and adverse cardiac events. 