Dr. Sandeep Bansal: Management Of STEMI With Renal Failure
Angioplasty not a possibility for a STEMI patient with a renal failure: a myth
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Dr. Sandeep Bansal
Head of Department-Cardiology
Safdarjung Hospital, Delhi
STEMI compounded with renal failure certainly makes angioplasty a difficult proposition, but not impossible unless the patient has end-stage renal failure and is too sick to undergo dialysis, says says Dr. Sandeep Bansal, an eminent cardiologist from Safdarjung Hospital, Delhi.
“In treating a STEMI patient with a chronic kidney disease (CKD) or chronic renal failure, EGFR is an important indicator, which shows the degree of renal failure. It also tells us whether a dialysis would be needed in the background for the procedure to be carried out safely,” he tells Dr. HK Chopra, President CSI (Cardiology Society of India).
“In patients with end stage renal failure who are too sick to undergo dialysis, our hands are tied and we can only give dual antiplatelet along with some blood thinners like enoxaparin.”
“Tenecteplase in the dose of 0.5 mg/kg is the best choice among thrombolytics when an angioplasty is not possible”
A high dose of statins and ACE inhibitors for the first 24 hours after an event of STEMI are the standard treatment.