Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI)

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Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI) On the Web

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FDA on Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI)

CDC on Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI)

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Blogs on Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI)

Directions to Hospitals Treating Percutaneous Coronary Intervention

Risk calculators and risk factors for Percutaneous coronary intervention ST-elevation myocardial infarction (STEMI)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1]

Intravenous Antiplatelet Therapy in patients of ST-Elevation Myocardial Infarction (STEMI) (DO NOT EDIT)[1]

Class III (No Benefit)
"1. Routine pre-catheterization laboratory (e.g., ambulance or emergency room) administration of glycoprotein IIb/IIIa inhibitors as part of an upstream strategy for patients with STEMI undergoing PCI is not beneficial.[2][3][4][5][6][7][8][9] (Level of Evidence: B)"
Class IIa
"1. In patients undergoing primary PCI treated with unfractionated heparin (UFH), it is reasonable to administer a glycoprotein IIb/IIIa inhibitor (abciximab, double-bolus eptifibatide, or high-bolus dose tirofiban), whether or not patients were pretreated with clopidogrel.[10][11][12][13][14][15][16] (For glycoprotein IIb/IIIa inhibitor administration in patients not pretreated with clopidogrel, (Level of Evidence: A); for glycoprotein IIb/IIIa inhibitor administration in patients pretreated with clopidogrel,(Level of Evidence: C))"
Class IIb
"1. In patients undergoing primary PCI with abciximab, it may be reasonable to administer intracoronary abciximab.[15][17][18][19][20][21][22][23][24][25][26][27][28][29][30] (Level of Evidence: B)"

References

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