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| | ==Definition of Multivessel Disease== |
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| | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| | For AEGIS-II inclusion criteria #5, multivessel disease criteria can be met by findings on the cardiac catheterization for the index MI, a prior cardiac catheterization, or both: |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' For patients at risk of developing HF, natriuretic peptide biomarker–based screening followed by team- based care, including a cardiovascular specialist optimizing GDMT, can be useful to prevent the development of left ventricular dysfunction (systolic or diastolic) or new-onset HF ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
| | * Index MI cardiac catheterization: 50% or greater stenosis of the left main or at least <b><u>2</u></b> coronary artery territories (LAD, LCX, RCA) (prior to any interventions performed) |
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| | * Prior cardiac catheterization: 50% or greater stenosis of left main or at least <b><u>2</u></b> coronary artery territories (LAD, LCx, RCA) (prior to any interventions performed) |
| | * Both: Index MI cardiac catheterization with 1 vessel with 50% or greater stenosis (prior to any interventions performed) <b><u>AND</u></b> prior PCI of at least 1 vessel different from index MI vessel |
| | * Prior multivessel CABG |
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| | Multivessel disease requires a 50% or greater stenosis in at least 2 of the 3 major epicardial artery territories (LAD, LCx, RCA) or the left main vessel. Branch vessel disease may qualify as part of the territory of that branch vessel (for example, a diagonal vessel is considered part of the LAD territory). For the purpose of this study, the ramus is considered part of the Left Circumflex artery territory. If a branch vessel is used as a qualifying vessel, that branch should be of large enough size to potentially undergo revascularization if clinically indicated, e.g. >2mm vessel size. |
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| | ==MVD Tool== |
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| | {{#Widget:MVD5}} |
| |colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
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| |bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Routine combined use of an [[ACEIs|ACE inhibitor]], [[Angiotensin II receptor blockers|ARB]], and [[aldosterone antagonist]] is not recommended for patients with current or prior symptoms of [[heart failure]] and reduced [[left ventricular ejection fraction]] ([[LVEF]]). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| | colspan="1" style="text-align:center; background:LightCoral; ; width: 300px"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
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| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[Congestive heart failure angiotensin receptor-neprilysin inhibitor|ARNI]] should not be administered concomitantly with [[ACE inhibitor|ACE inhibitors]] or within 36 hours of the last dose of an ACE inhibitor. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
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| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' [[Congestive heart failure angiotensin receptor-neprilysin inhibitor|ARNI]] should not be administered to patients with a history of [[angioedema]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-EO]])'' <nowiki>"</nowiki>
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| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Angiotensin II receptor blockers]] are reasonable to use as alternatives to [[ACEIs|ACE inhibitors]] as first-line therapy for patients with mild to moderate [[heart failure]] and reduced [[left ventricular ejection fraction]] ([[LVEF]]), especially for patients already taking [[Angiotensin II receptor blockers|ARBs]] for other indications.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
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| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Angiotensin II receptor blockers]] are reasonable to use as alternatives to [[ACEIs|ACE inhibitors]] as first-line therapy for patients with mild to moderate [[heart failure]] and reduced [[left ventricular ejection fraction]] ([[LVEF]]), especially for patients already taking [[Angiotensin II receptor blockers|ARBs]] for other indications.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
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Definition of Multivessel Disease
For AEGIS-II inclusion criteria #5, multivessel disease criteria can be met by findings on the cardiac catheterization for the index MI, a prior cardiac catheterization, or both:
- Index MI cardiac catheterization: 50% or greater stenosis of the left main or at least 2 coronary artery territories (LAD, LCX, RCA) (prior to any interventions performed)
- Prior cardiac catheterization: 50% or greater stenosis of left main or at least 2 coronary artery territories (LAD, LCx, RCA) (prior to any interventions performed)
- Both: Index MI cardiac catheterization with 1 vessel with 50% or greater stenosis (prior to any interventions performed) AND prior PCI of at least 1 vessel different from index MI vessel
- Prior multivessel CABG
Multivessel disease requires a 50% or greater stenosis in at least 2 of the 3 major epicardial artery territories (LAD, LCx, RCA) or the left main vessel. Branch vessel disease may qualify as part of the territory of that branch vessel (for example, a diagonal vessel is considered part of the LAD territory). For the purpose of this study, the ramus is considered part of the Left Circumflex artery territory. If a branch vessel is used as a qualifying vessel, that branch should be of large enough size to potentially undergo revascularization if clinically indicated, e.g. >2mm vessel size.
MVD Tool