2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

Antman, Elliott M.; Hand, Mary M.; Armstrong, Paul W.; Bates, Eric R.; Green, Lee A.; Halasyamani, Lakshmi; Hochman, Judith S.; Krumholz, Harlan M.; Lamas, Gervasio A.; Mullany, Charles J.; Pearle, David L.; Sloan, Michael A.; Smith, Sidney C.; Anbe, Daniel T.; Kushner, Frederick G.; Ornato, Joseph P.; Jacobs, Alice K.; Adams, Cynthia D.; Anderson, Jeffrey L.; Buller, Christopher E.; Creager, Mark A.; Ettinger, Steven M.; Halperin, Jonathan L.; Hunt, Sharon A.; Lytle, Bruce W.; Nishimura, Rick A.; Page, Richard L.; Riegel, Bárbara; Tarkington, Lynn G.; Yancy, Clyde W.

doi:10.1161/circulationaha.107.188209

Cited by 1,167 publications

(412 citation statements)

References 94 publications

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“…Admission was used to track the time of presentation because we lacked information about time to presentation at the hospital. We evaluated the use of treatments recommended by the 2010 National Guideline for STEMI,18 which are consistent with 2007 U.S. guidelines 19. Rates of utilization were assessed only in patients considered to be ideal for the treatment, defined as patients without accepted contraindications.…”

Section: Methodsmentioning

confidence: 99%

Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study

Du¹,

Spatz²,

Dreyer

et al. 2016

JAHA

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BackgroundChina is experiencing a marked increase in ST‐segment elevation myocardial infarction hospitalizations, with 30% occurring among women and higher risk of in‐hospital death in relatively younger age groups (<70). Yet, little is known about sex differences in ST‐segment elevation myocardial infarction presentation and management.Methods and ResultsIn a nationally representative sample of patients with ST‐segment elevation myocardial infarction admitted to 162 Chinese hospitals in 2001, 2006, and 2011, we examined sex differences in hospitalization rates, clinical profiles, and quality of care. Among 11 986 patients, the proportion of women was unchanged between 2001 and 2011. The estimated national rates of hospital admission per 100 000 people increased from 4.6 in 2001 to 18.0 in 2011 among men (3.9‐fold increase) and from 1.9 to 8.0 among women (4.2‐fold increase) (P trend<0.0001). The median age of women increased from 68 years in 2001 to 72 years in 2011 (P trend<0.001); however, there was no age change in men (63 years in 2011) (P trend=0.48). After accounting for age, women had a higher frequency of comorbidities. Although there were significant sex differences in the time interval of >12 hours between symptom onset and admission time in 2001, since 2006 delays in presentation were comparable between women and men. Fewer women without contraindications received evidence‐based therapies than men, including reperfusion (57.5% versus 44.2%), early aspirin (88.8% versus 85.9%), and clopidogrel (56.9% versus 52.5%, P<0.001 for all) and the differences were largely unchanged over time.ConclusionsWomen experienced a higher increase in hospitalization rates for ST‐segment elevation myocardial infarction in China between 2001 and 2011 and were less likely to receive evidence‐based therapies, especially reperfusion. In addition to efforts to improve quality of care generally, understanding the reasons for this sex disparity and addressing these differences in care should be a priority.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01624883.

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Section: Methodsmentioning

confidence: 99%

Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study

Du¹,

Spatz²,

Dreyer

et al. 2016

JAHA

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“…6,7 The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, which examined the effects of eptifibatide in patients with ACS, concluded that compared to younger patients, the elderly (≥65 y) demonstrated only a slight trend towards benefit in terms of death/MI, and there was a significant increase in bleeding in this subgroup. 12 Sadeghi et al concluded that elderly patients (>80 y) had a higher incidence of access and non-access site bleeding, but no significant increase in intracranial hemorrhage or increased transfusion rates when treated with GP IIb/IIIa inhibitors.…”

Section: Glycoprotein Iib/iiia Inhibitors (Gp Iib/iiia)mentioning

confidence: 99%

“…6,7 However, it was shown that efficacy and the balance of benefit and risk from the use of these agents may be altered by age-related changes in thrombosis and fibrinolysis. Observational studies have linked advanced age to higher levels of heparin in the blood resulting in increased activated partial thromboplastin times and heparin associated bleeding.…”

Section: Heparinmentioning

confidence: 99%

Acute Coronary Syndrome in the Elderly

Shanmugasundaram

Alpert

2009

Clinical Cardiology

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The spectrum of acute coronary syndrome (ACS) including unstable angina, non–ST‐elevation myocardial infarction and ST‐elevation myocardial infarction accounts for increasing numbers of deaths among persons age ≥ 65 years in the US. This is important given demographic changes involving falling birth rates and increasing life expectancy. Elderly patients are likely to benefit the most from treatment of ACS, even though community practice still demonstrates less use of cardial medications as an early‐invasive approach among this population. Copyright © 2009 Wiley Periodicals, Inc.

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“…However, enrollment in the SOLID‐ TIMI 52 trial occurred between 2009 and 2011, so neither factor would have affected statin use in the current study. Although some guidelines that were available at the time of the trial recommended the routine use of high‐potency statins in patients after ACS,7, 17, 18 other guidelines focused primarily on achieving LDL cholesterol concentrations <100 or <70 mg/dL in high‐risk patients 19, 20. We observed, however, that the use of high‐potency statins was also low in patients who had not achieved desired LDL cholesterol target goals.…”

Section: Discussionmentioning

confidence: 74%

Predictors of Nonuse of a High‐Potency Statin After an Acute Coronary Syndrome: Insights From the Stabilization of Plaques Using Darapladib‐Thrombolysis in Myocardial Infarction 52 (SOLID‐TIMI 52) Trial

Eisen

Cannon

Braunwald

et al. 2017

JAHA

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BackgroundHigh‐potency statins reduce cardiovascular events after acute coronary syndromes but remain underused in clinical practice. We examined predictors of nonuse of high‐potency statins after acute coronary syndromes.Methods and ResultsThe Stabilization of pLaques usIng Darapladib‐Thrombolysis in Myocardial Infarction (SOLID‐TIMI 52) trial enrolled patients after an acute coronary syndrome in 36 countries between 2009 and 2011. Statin use was strongly encouraged throughout the trial, and statin potency was at the discretion of the treating physician. A high‐potency statin was defined as ≥40 mg atorvastatin, ≥20 mg rosuvastatin, or 80 mg simvastatin daily. Predictors of nonuse of high‐potency statins were examined using logistic regression. Of the patients included (n=12 446), 11 850 (95.2%) were treated with a statin at baseline after acute coronary syndrome (median 14 days), but only 5212 (41.9%) were on a high‐potency statin. Selected patient factors associated with nonuse of high‐potency statins included age ≥75 years (odds ratio 1.39, 95% CI 1.24–1.56), female sex (odds ratio 1.11, 95% CI 1.02–1.22), renal dysfunction (odds ratio 1.17, 95% CI 1.03–1.32), and heart failure during hospital admission (odds ratio 1.43, 95% CI 1.27–1.62). At 3 months after baseline, only 49% of patients had low‐density lipoprotein cholesterol <70 mg/dL. Among the 5490 patients (59%) who were not on a high‐potency statin at 3 months, lower low‐density lipoprotein cholesterol was a predictor of nonuse of a high‐potency statin after a median of 2.3 years (odds ratio 1.15 for 10 mg/dL decrease, 95% CI 1.11–1.19).ConclusionDespite the widespread use of statins after acute coronary syndromes, most patients are not treated with high‐potency statins early and late after the event, including patients at the highest risk of recurrent cardiovascular events.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01000727.

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2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

Cited by 1,167 publications

References 94 publications

Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study

Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study

Acute Coronary Syndrome in the Elderly

Predictors of Nonuse of a High‐Potency Statin After an Acute Coronary Syndrome: Insights From the Stabilization of Plaques Using Darapladib‐Thrombolysis in Myocardial Infarction 52 (SOLID‐TIMI 52) Trial

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