ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies -intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), antiinflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre-and post-conditioning and stem cell therapy -have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results: These therapies need confirmation in larger studies to be implemented in clinical practice
PrevalenceThe worldwide prevalence of ischemic heart disease is approximately 111 million cases, with 7.3 million cases of fatal acute myocardial infarction (AMI) in 2015. The inadequate treatment of patients with AMI is associated with significant increases in morbidity and mortality. 1
ObjectivesThe objective of this systematic review is to evaluate the evidence of different reperfusion therapies in STsegment elevation AMI (STEMI), selecting mainly randomized controlled trials and systematic reviews that address major cardiovascular clinical outcomes.
MethodsThe review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched the PubMed database for the terms "acute myocardial infarction" and "reperfusion therapy", which yielded 9,885 results. After applying the following search filters -type of abstract: "text and full text"; type of article: "metaanalysis, review, systematic review and randomized clinical trial", and date of publication: "last 5 years", and language: "English" -127 articles were obtained. In addition, research was conducted at the Cochrane Central Register of Controlled Trials using the terms "acute myocardial infarction" and "reperfusion therapy", in English, between 2018 and 2020, which revealed 64 clinical trials, already excluding duplicates. Of the 191
