Abstract：Acute ST-segment elevation myocardial infarction(STEMI) is an acute cardiovascular event with coronary thrombosis. Antithrombotic runs through the whole process of both emergent percutaneous coronary intervention and thrombolytic therapy. In recent years, numerous new guidelines about the STEMI have been issued successively by European Society of Cardiology(ESC), American College of Cardiology Foundation(ACCF) and American Heart Association(AHA), in view of some of the published results of large randomized clinical trials. The new guidelines state that once acute STEMI is identified, immediate antiplatelet and anticoagulant therapy should be launched. The loading doses of aspirin (300 mg) and ADP receptor antagonists (clopidogrel 300-600 mg, prasugrel 60 mg, ticagrelor 180 mg) are in the front of antiplatelet therapy. The ESC guidelines prefer ticagrelor and prasugrel .The two guidelines employed a single daily maintenance dose of lowdose aspirin (75-100 mg/d). In emergency PCI, the guidelines recommend that low molecular weight heparin is still important but less glamorous than before and its sustained time is no longer than 8 days.Meanwhile, based on efficacy and safety considerations, bivalirudin would be more preferable in STEMI undergoing emergency PCI , especially for the patients with high risk of bleeding.
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2014, Vol. 23 
