Pharmaco-Invasive Therapy is a Critical Option in Nigerian Stemi Treatment: A Review

Abstract

Primary percutaneous coronary intervention (PCI) is the recommended reperfusion approach in patients with ST-segment elevation myocardial infarction (STEMI), When conducted in a timely and by skilled operators. This technique, however, has proven to have limitations in areas without PCI facilities and with long wait times between the initial medical contact and balloon because to logistical issues and a lack of skilled operators.  In STEMI patients, pre-treatment with a fibrinolytic prior to PCI has the potential to give early pharmacologic reperfusion before definitive PCI. According to current evidence, assisted PCI has no advantage over main PCI.  The role for pharmaco-invasive reperfusion, defined as pharmacological re-perfusion followed by rapid transfer for routine delayed coronary angiography and PCI may still be considered in centers without on-site PCI capability. Patients presenting with STEMI in Nigeria have a lot of challenges which include delay in decision making, cost of revascularization, religious believes, ignorance and availability of cardiac catheterization and the skillful personnel for the operation. To meet with the demand and challenges of Myocardial infarction in Nigeria, we need the mode of treatment that is beneficial, cost effective and lifesaving. Hence, pharmaco-invasive is the way for Nigeria and other low-income countries of sub-Saharan Africa.