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It is therefore not probably for everyone. Unfortunately nevhodny navrh the delays of primary PCI are substantial. In many countries the delays are unavoidable and prehospital thrombolysis is necessary. The proposed classification definitely warrants further debate.

Also as has been suggested lysis is nevhodny navrh being used worldwide judging by the responses we are getting to the STREAM trial.

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In my country Italythe latest nationwide data on the reperfusion treatment are the ones below. The proposal could be applied in nevhodny navrh countries, of course. It is worth of further debate with ultimate aim to unify the management across the countries for the maximal benefit of all patients.

It will be important to obtain rigorous data that nevhodny navrh to define the high risk group. Unfortunately, treatment strategies are at this stage difficult to match with this concept.

In addition, the main difference in management will be in the group of patients that showed ischemia on admission and will be sent in your proposal directly to the cathlab, whereas in many situations non-STE ischemia will disappear after 30—60 minutes of anti-anginal drugs and those patients will get invasive evaluation 24—72 h after admission.


Your proposal is also an opportunity to critically evaluate the current ACS classification and to compare the advantage and the disadvantage of both classifications systems.

Although any earlier treatment that minimises myocardial damage may prove effective in the longer-term, this is probably dependent on nevhodny navrh degree of ischaemia, vulnerable nevhodny navrh, potentially for harm during procedures etc.

As long as the patient is in the right centre, the current guidelines allow for this.


In my view it would be critical to distinguish type 1 myocardial infarction nevhodny navrh type 2 secondary causes for nevhodny navrh following arrhythmia or heart failure as these have different therapeutic implications.

This distinction nevhodny navrh on the clinical context. This is certainly intuitive however, and future studies should collect this data. The logistic situation in Germany is very different. Taking these considerations into account — at least in my view — your proposed new ACS classification would not help improving the current ACS-care in Germany.

Nevhodný - English translation – Linguee

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