Reperfusion in 2011: Implementing the Best Strategy for the Greatest Number of Patients——Dr. Harry Suryapranata Interview
If you talk about reperfusion therapy I think it is necessary to go back to what it was that caused it. One of the latest breakthroughs in interventional cardiology was back in 1993 when the treatment of acute myocardial infarction (MI) patients changed away from medical therapy.
International Circulation: Are there any special factors for peri-procedure drug therapy and stent selection that we need to think when we are treating patients with STEMI?
Harry Suryapranata: In the beginning we conduct randomized clinical trials comparing BMS versus balloon angioplasty where you see somewhat of a difference but major difference in terms of mortality. Angioplasty or coronary intervention for acute MI already has brought mortality rates down very low, let’s say less than 5% in the hospital. How can we do better? I think there are numerous potential efforts. The only effort that is key in my opinion is to bring time delay down. Not to bring balloon-stent time down. If you follow the other developments of PCI materials and PCI techniques has increased incredibly. It is all feasible and all effective somewhat. Sometimes you are punished by the fact that there are more stent thromboses in this cohort of patients. Therefore, since 2008, we have used Geni-stent in all cases of STEMI because we believe that it will be safer than other stents because of the feature of antibody coatings that target endothelial progenitor cells from the patients own circulation. We know from experiments that, during acute states of infarction, the production of endothelial progenitor cells is high. There is a three-fold increase in these cells when compared to normal. So, using that concept we have been treating patients since 2008 with Geni-stents and have very good results.