ST elevation myocardial infarction management of patients who were not reperfused: Difference between revisions

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{{Infobox_Disease |
{{ST elevation myocardial infarction}}
  Name          = Myocardial infarction|
{{CMG}}'''Associate Editor-In-Chief:''';  {{CZ}}
  Image          = AMI scheme.png |
  Caption        = Diagram of a '''myocardial infarction''' (2) of the tip of the [[Sternocostal surface|anterior wall of the heart]] (an ''apical infarct'') after occlusion (1) of a branch of the [[left coronary artery]] (LCA, [[right coronary artery]] = RCA).|
  DiseasesDB    = 8664 |
  ICD10          = {{ICD10|I|21||i|20}}-{{ICD10|I|22||i|20}} |
  ICD9          = {{ICD9|410}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 000195 |
  eMedicineSubj  = med |
  eMedicineTopic = 1567 |
  eMedicine_mult = {{eMedicine2|emerg|327}} {{eMedicine2|ped|2520}} |
  MeshID        = |
}}
 
'''For patient information click [[Heart attack (patient information)|here]]'''
 
{{SI}}
{{WikiDoc Cardiology Network Infobox}}
__NOTOC__
{{CMG}}
 
'''Associate Editor-In-Chief:''' {{CZ}}
 
==Mechanism of Benefit==


==Clinical Trial Data==
==Clinical Trial Data==
[[image:FibrinolyticTxvsNoRep.jpg|thumb|center|300px|Adjusted probability of death or cerebral bleeding in relation to fibrinolytic therapy in patients with [[ST elevation myocardial infarction]] (STEMI) who were 75 years or older (dotted line) versus that among patients with STEMI not receiving fibrinolysis (solid line). At 30 days and 1 year this was 23% and 32% versus 26% and 36%, respectively. <ref name="pmid12719207">{{cite journal |author=Stenestrand U, Wallentin L |title=Fibrinolytic therapy in patients 75 years and older with ST-segment-elevation myocardial infarction: one-year follow-up of a large prospective cohort |journal=Arch. Intern. Med. |volume=163 |issue=8 |pages=965–71 |year=2003 |month=April |pmid=12719207 |doi=10.1001/archinte.163.8.965 |url=}}</ref>]]
[[image:FibrinolyticTxvsNoRep.jpg|none|300px|<ref name="pmid12719207">{{cite journal |author=Stenestrand U, Wallentin L |title=Fibrinolytic therapy in patients 75 years and older with ST-segment-elevation myocardial infarction: one-year follow-up of a large prospective cohort |journal=Arch. Intern. Med. |volume=163 |issue=8 |pages=965–71 |year=2003 |month=April |pmid=12719207 |doi=10.1001/archinte.163.8.965 |url=}}</ref>]]
==Side Effects==
Adjusted probability of death or cerebral bleeding in relation to fibrinolytic therapy in patients with [[ST elevation myocardial infarction]] (STEMI) who were 75 years or older (dotted line) versus that among patients with STEMI not receiving fibrinolysis (solid line). At 30 days and 1 year this was 23% and 32% versus 26% and 36%, respectively.


==ACC/AHA Guidelines (DO NOT EDIT)<ref name="pmid18071078">{{cite journal |author=Antman EM, Hand M, Armstrong PW, ''et al'' |title=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, Writing on Behalf of the 2004 Writing Committee |journal=Circulation |volume=117 |issue=2 |pages=296–329 |year=2008 |month=January |pmid=18071078 |doi=10.1161/CIRCULATIONAHA.107.188209 |url=}}</ref>==
==ACC/AHA Guidelines (DO NOT EDIT)<ref name="pmid18071078">{{cite journal |author=Antman EM, Hand M, Armstrong PW, ''et al'' |title=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, Writing on Behalf of the 2004 Writing Committee |journal=Circulation |volume=117 |issue=2 |pages=296–329 |year=2008 |month=January |pmid=18071078 |doi=10.1161/CIRCULATIONAHA.107.188209 |url=}}</ref>==
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*The 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction <ref name="pmid18071078">{{cite journal |author=Antman EM, Hand M, Armstrong PW, ''et al'' |title=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, Writing on Behalf of the 2004 Writing Committee |journal=Circulation |volume=117 |issue=2 |pages=296–329 |year=2008 |month=January |pmid=18071078 |doi=10.1161/CIRCULATIONAHA.107.188209 |url=}}</ref>
*The 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction <ref name="pmid18071078">{{cite journal |author=Antman EM, Hand M, Armstrong PW, ''et al'' |title=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, Writing on Behalf of the 2004 Writing Committee |journal=Circulation |volume=117 |issue=2 |pages=296–329 |year=2008 |month=January |pmid=18071078 |doi=10.1161/CIRCULATIONAHA.107.188209 |url=}}</ref>


==See Also==
==Related Chapters==
* [[The Living Guidelines: STEMI | The STEMI Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
* [[The Living Guidelines: STEMI | The STEMI Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{Circulatory system pathology}}
{{SIB}}


[[Category:Cardiology]]
[[Category:Cardiology]]

Revision as of 16:37, 31 May 2012

Acute Coronary Syndrome Main Page

ST Elevation Myocardial Infarction Microchapters

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Patient Information

Overview

Pathophysiology

Pathophysiology of Vessel Occlusion
Pathophysiology of Reperfusion
Gross Pathology
Histopathology

Causes

Differentiating ST elevation myocardial infarction from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History and Complications

Risk Stratification and Prognosis

Pregnancy

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Diagnostic Criteria

History and Symptoms

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Laboratory Findings

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The coronary care unit
The step down unit
STEMI and Out-of-Hospital Cardiac Arrest
Pharmacologic Reperfusion
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Fibrinolysis
Reperfusion at a Non–PCI-Capable Hospital:Recommendations
Mechanical Reperfusion
The importance of reducing Door-to-Balloon times
Primary PCI
Adjunctive and Rescue PCI
Rescue PCI
Facilitated PCI
Adjunctive PCI
CABG
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy
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Unfractionated heparin
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Direct Thrombin Inhibitor Therapy
Factor Xa Inhibition
DVT prophylaxis
Long term anticoagulation
Antiplatelet Agents
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Magnesium Therapy
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Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

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ICD implantation within 40 days of myocardial infarction
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ST elevation myocardial infarction management of patients who were not reperfused On the Web

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor-In-Chief:; Cafer Zorkun, M.D., Ph.D. [2]

Clinical Trial Data

[1]
[1]

Adjusted probability of death or cerebral bleeding in relation to fibrinolytic therapy in patients with ST elevation myocardial infarction (STEMI) who were 75 years or older (dotted line) versus that among patients with STEMI not receiving fibrinolysis (solid line). At 30 days and 1 year this was 23% and 32% versus 26% and 36%, respectively.

ACC/AHA Guidelines (DO NOT EDIT)[2]

“

Class I

1. It is reasonable for patients with STEMI who do not undergo reperfusion therapy to be treated with anticoagulant therapy (non-UFH regimen) for the duration of the index hospitalization, up to 8 days. (Level of Evidence: B) Convenient strategies that can be used include those with LMWH (Level of Evidence: C) or fondaparinux (Level of Evidence: B) using the same dosing regimens as for patients who receive fibrinolytic therapy.

”

Sources

  • The 2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction [3]
  • The 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction [2]

Related Chapters

References

  1. ↑ Stenestrand U, Wallentin L (2003). "Fibrinolytic therapy in patients 75 years and older with ST-segment-elevation myocardial infarction: one-year follow-up of a large prospective cohort". Arch. Intern. Med. 163 (8): 965–71. doi:10.1001/archinte.163.8.965. PMID 12719207. Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 Antman EM, Hand M, Armstrong PW; et al. (2008). "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, Writing on Behalf of the 2004 Writing Committee". Circulation. 117 (2): 296–329. doi:10.1161/CIRCULATIONAHA.107.188209. PMID 18071078. Unknown parameter |month= ignored (help)
  3. ↑ Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK (2004). "ACC/AHA 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 (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction)". Circulation. 110 (9): e82–292. PMID 15339869. Unknown parameter |month= ignored (help)


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