The Living Guidelines: STEMI Immediate (or Emergency) Invasive Strategy and Rescue PCI Polling Results for CLASS IIa Guidelines
1- A strategy of coronary angiography with intent to perform PCI (or emergency CABG) is reasonable in patients ≥75 years of age who have received fibrinolytic therapy, and are in cardiogenic shock, provided that they are suitable candidates for revascularization. (Class IIa, Level of Evidence: B) [1]
<Poll> AHA / ACC 2007 STEMI Guidelines for Immediate (or Emergency) Invasive Strategy and Rescue PCI Class IIa Recommendation 1 should be CLASS I CLASS IIa CLASS IIb CLASS III </poll>
2- It is reasonable to perform rescue PCI for patients with 1 or more of the following:[2]
a. Hemodynamic or electrical instability. (Class IIa, Level of Evidence: C)
<Poll> AHA / ACC 2007 STEMI Guidelines for Immediate (or Emergency) Invasive Strategy and Rescue PCI Class IIa Recommendation 2a should be CLASS I CLASS IIa CLASS IIb CLASS III </poll>
b. Persistent ischemic symptoms. (Class IIa, Level of Evidence: C)
<Poll> AHA / ACC 2007 STEMI Guidelines for Immediate (or Emergency) Invasive Strategy and Rescue PCI Class IIa Recommendation 2b should be CLASS I CLASS IIa CLASS IIb CLASS III </poll>
3. A strategy of coronary angiography with intent to perform rescue PCI is reasonable for patients in whom fibrinolytic therapy has failed (ST segment elevation < 50% resolved after 90 minutes following initiation of fibrinolytic therapy in the lead showing the worst initial elevation) and a moderate or large area of myocardium at risk (anterior MI, inferior MI with right ventricular involvement or precordial ST segment depression). (Class IIa, Level of Evidence: B) [3]
<Poll> AHA / ACC 2007 STEMI Guidelines for Immediate (or Emergency) Invasive Strategy and Rescue PCI Class IIa Recommendation 3 should be CLASS I CLASS IIa CLASS IIb CLASS III </poll>
Reference
- ↑ STEMI Focused Update, 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Developed in Collaboration With the Canadian Cardiovascular Society; Endorsed by the American Academy of Family Physicians; 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. Antman E.M., Hant M., Armstrong P.W., et. al., 2007 Focused updates of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines Circulation 117 (2):296-329, January 15, 2008.
- ↑ STEMI Focused Update, 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Developed in Collaboration With the Canadian Cardiovascular Society; Endorsed by the American Academy of Family Physicians; 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. Antman E.M., Hant M., Armstrong P.W., et. al., 2007 Focused updates of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines Circulation 117 (2):296-329, January 15, 2008.
- ↑ STEMI Focused Update, 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Developed in Collaboration With the Canadian Cardiovascular Society; Endorsed by the American Academy of Family Physicians; 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. Antman E.M., Hant M., Armstrong P.W., et. al., 2007 Focused updates of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines Circulation 117 (2):296-329, January 15, 2008.