Sandbox: STEMI: Difference between revisions
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! style="width:50%" | '''2017''' | ! style="width:50%" | '''2017''' | ||
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| bgcolor="LemonChiffon" | | | bgcolor="LemonChiffon" | IIa - Radial access || bgcolor="LightGreen" | I - Radial access (MATRIX) | ||
|- | |- | ||
| bgcolor="LemonChiffon" | DES over BMS || bgcolor="LightGreen" | DES over BMS (EXAMINATION, COMFORTABLE-AMI, NORSTENT) | | bgcolor="LemonChiffon" | IIa - DES over BMS || bgcolor="LightGreen" | I - DES over BMS (EXAMINATION, COMFORTABLE-AMI, NORSTENT) | ||
|- | |- | ||
| bgcolor="LemonChiffon" | | | bgcolor="LemonChiffon" | III - Complete Revascularization || bgcolor="LightCoral" | IIa - Complete Revascularization (PRAMI, DANAMI-3-PRIMULTI, CVLPRIT, Compare-Acute) | ||
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| bgcolor="LightCoral" | | | bgcolor="LightCoral" | IIa - Complete Revascularization || bgcolor="LemonChiffon" | III - Thrombus Aspiration (TOTAL, TASTE) | ||
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| bgcolor="LightGreen" | Bivalirudin || bgcolor="LemonChiffon" | Bivalirudin (MATRIX, HEAT-PPCI) | | bgcolor="LightGreen" | I - Bivalirudin || bgcolor="LemonChiffon" | IIa -Bivalirudin (MATRIX, HEAT-PPCI) | ||
|- | |- | ||
| bgcolor="LemonChiffon" | Enoxaparin || bgcolor="LemonChiffon" | Enoxaparin (ATOLL, Meta-analysis) | | bgcolor="LemonChiffon" | IIb - Enoxaparin || bgcolor="LemonChiffon" | IIa - Enoxaparin (ATOLL, Meta-analysis) | ||
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| bgcolor="LemonChiffon" | Early Hospital Discharge || bgcolor="LemonChiffon" | Early Hospital Discharge (Small trials & observational data) | | bgcolor="LemonChiffon" | IIb - Early Hospital Discharge || bgcolor="LemonChiffon" | IIa - Early Hospital Discharge (Small trials & observational data) | ||
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| bgcolor="LightGreen" | (Oxygen when SaO2 <95%) OXYGEN || bgcolor="LightGreen" | OXYGEN (Oxygen when SaO2 <90%) AVOID, DETO2X | | bgcolor="LightGreen" | I - (Oxygen when SaO2 <95%) OXYGEN || bgcolor="LightGreen" | I - OXYGEN (Oxygen when SaO2 <90%) AVOID, DETO2X | ||
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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) |
Revision as of 14:33, 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 |
---|---|
IIa - Radial access | I - Radial access (MATRIX) |
IIa - DES over BMS | I - DES over BMS (EXAMINATION, COMFORTABLE-AMI, NORSTENT) |
III - Complete Revascularization | IIa - Complete Revascularization (PRAMI, DANAMI-3-PRIMULTI, CVLPRIT, Compare-Acute) |
IIa - Complete Revascularization | III - Thrombus Aspiration (TOTAL, TASTE) |
I - Bivalirudin | IIa -Bivalirudin (MATRIX, HEAT-PPCI) |
IIb - Enoxaparin | IIa - Enoxaparin (ATOLL, Meta-analysis) |
IIb - Early Hospital Discharge | IIa - Early Hospital Discharge (Small trials & observational data) |
I - (Oxygen when SaO2 <95%) OXYGEN | I - 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 | IIa - 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) | |
III - Routine use of deferred stenting. DANAMI 3-DEFER |