Sandbox: STEMI: Difference between revisions
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| (Same dose i.V in all patients) TNK-tPA || TNK-tPA (Half dose i.V. in Pts ≥75 years, STREAM) | | (Same dose i.V in all patients) TNK-tPA || TNK-tPA (Half dose i.V. in Pts ≥75 years, STREAM) | ||
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===AMI-STEMI - 2017 NEW RECOMMENDATIONS=== | |||
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| bgcolor="LemonChiffon" | IIa - Additional lipid lowering therapy if LDL >1.8 mmol/L (70 mg/dL) despite on maximum tolerated statins. IMPROVE-IT, FOURIER || "LemonChiffon" | Complete revascularization during index primary PCI in STEMI patients in shock. (Expert opinion) | |||
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| bgcolor="LemonChiffon" | IIb - 1) Cangrelor if P2Y12 inhibitors have not been given. (CHAMPION) 2) Switch to potent P2Y12 inhibitors 48 hours after fibrinolysis. (Expert opinion) 3)Extend Ticagrelor up to 36 months in high-risk patients. (PEGASUS-TIMI 54) 4)Use of polypill to increase adherence. (FOCUS) || | |||
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| bgcolor="LightCoral" | II I- Routine use of deferred stenting. DANAMI 3-DEFER || | |||
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Revision as of 14:28, 27 October 2017
2017 ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation
Changes in Recommendations
What is new in 2017 Guidelines on AMI-STEMI?
2012 | 2017 |
---|---|
Radial access | Radial access (MATRIX) |
DES over BMS | DES over BMS (EXAMINATION, COMFORTABLE-AMI, NORSTENT) |
Complete Revascularization | Complete Revascularization (PRAMI, DANAMI-3-PRIMULTI, CVLPRIT, Compare-Acute) |
Complete Revascularization | Thrombus Aspiration (TOTAL, TASTE) |
Bivalirudin | Bivalirudin (MATRIX, HEAT-PPCI) |
Enoxaparin | Enoxaparin (ATOLL, Meta-analysis) |
Early Hospital Discharge | Early Hospital Discharge (Small trials & observational data) |
(Oxygen when SaO2 <95%) OXYGEN | OXYGEN (Oxygen when SaO2 <90%) AVOID, DETO2X |
(Same dose i.V in all patients) TNK-tPA | TNK-tPA (Half dose i.V. in Pts ≥75 years, STREAM) |
AMI-STEMI - 2017 NEW RECOMMENDATIONS
IIa - Additional lipid lowering therapy if LDL >1.8 mmol/L (70 mg/dL) despite on maximum tolerated statins. IMPROVE-IT, FOURIER | Complete revascularization during index primary PCI in STEMI patients in shock. (Expert opinion) |
IIb - 1) Cangrelor if P2Y12 inhibitors have not been given. (CHAMPION) 2) Switch to potent P2Y12 inhibitors 48 hours after fibrinolysis. (Expert opinion) 3)Extend Ticagrelor up to 36 months in high-risk patients. (PEGASUS-TIMI 54) 4)Use of polypill to increase adherence. (FOCUS) | |
II I- Routine use of deferred stenting. DANAMI 3-DEFER |