Manejo del Infarto Agudo al Miocardio con Elevación del Segmento ST

Background: In Mexico, the National Institute of Statistics and Geography (INEGI) recorded 200,535 cases of mortality due to heart disease during 2022, being the leading cause of death in people aged 45 to 54 years and over 65 years of age ST-segment elevation acute myocardial infarction (STEMI) is a cardiovascular emergency, with the potential for morbidity and mortality and the priority of reperfusion therapy Objectives: To review the definitions, classifications, risk factors, diagnosis, and management of ST-segment elevation myocardial infarction with priority for coronary reperfusion and a focus on early pharmacoinvasive strategy. Inclusion criteria: Scientific articles written in the adult population with STEMI, in Spanish, English, and Portuguese, between 2018 and 2023. Methodology: A systematic search was performed in PUDMED, LILACS, and COCHRANE, identifying 1,071 articles, of which 48 met the inclusion criteria. Results: Patients with an initial diagnosis of STEMI require immediate reperfusion therapy (percutaneous cardiological intervention primary (PCI) or fibrinolysis if primary PCI cannot be performed within the first 120 minutes (min) of diagnosis). However, in some situations primary PCI is not an immediate option and fibrinolysis should be started as part of the pharmacoinvasive strategy, provided that it can be performed within the first 12 hours of symptom onset. Conclusion: Coronary reperfusion is the main goal of treatment for patients with STEMI, and pharmacoinvasive therapy is ideal in an environment without rapid access to a haemodynamics or interventional cardiology centre; Always keeping in mind the premise that time is myocardium, time is organ, time is life.