2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner, Frederick G.; Hand, Mary M.; Smith, Sidney C.; King, Spencer B.; Anderson, Jeffrey L.; Antman, Elliott M.; Bailey, Steven R.; Bates, Eric R.; Blankenship, James C.; Casey, Donald E.; Green, Lee A.; Hochman, Judith S.; Jacobs, Alice K.; Krumholz, Harlan M.; Morrison, Douglass A.; Ornato, Joseph P.; Pearle, David L.; Peterson, Eric D.; Sloan, Michael A.; Whitlow, Patrick L.; Williams, David O.

doi:10.1016/j.jacc.2009.10.015

Cited by 1,448 publications

(681 citation statements)

References 155 publications

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“…The most recent update in 2009, however, states that in patients with CKD undergoing angiography who are not on chronic dialysis, either an IOCM (level of evidence: A) or a LOCM other than ioxaglate or iohexol is indicated (level of evidence: B) [50]. We anticipate our results may stimulate specific recommendations for IA and IV forms of angiography in the future.…”

Section: Discussionmentioning

confidence: 91%

Effects of Intra-Arterial and Intravenous Iso-Osmolar Contrast Medium (Iodixanol) on the Risk of Contrast-Induced Acute Kidney Injury: A Meta-Analysis

McCullough

Brown

2011

Cardiorenal Med

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Background: The iso-osmolar contrast agent iodixanol may be associated with a lower incidence of contrast-induced acute kidney injury (CI-AKI) than low-osmolar contrast media (LOCM), but previous meta-analyses have yielded mixed results. Objectives: To compare the incidence of CI-AKI between iodixanol and LOCM. Methods: Studies were identified from literature searches to December 2009, clinicaltrials.gov, and conference abstracts from the past 2 years including 2010. Only prospective, randomized comparisons between iodixanol and LOCM with CI-AKI [increase in serum creatinine (sCr) ≧0.5 mg/dl or ≧25% from baseline, as defined in the trial] as a primary and/or secondary endpoint and a Jadad score ≧2 were included. A random-effects model was used to obtain pooled relative risks (RRs) for CI-AKI in analyses based on route of administration [intra-arterial (IA) or intravenous (IV)], definition of CI-AKI, and timing of sCr measurements. Results: 145 potential articles were identified, of which 25 were included in the meta-analysis. Following IA administration (n = 19), the RR for CI-AKI (≧0.5 mg/dl definition) with iodixanol, compared with LOCM, was 0.462 [95% confidence interval (CI): 0.272–0.786, p = 0.004, 15 studies]. Using the ≧25% definition, there was a lower incidence of CI-AKI with iodixanol versus LOCM, but the difference was not statistically significant (RR: 0.577, 95% CI: 0.297–1.12, p = 0.104, 11 studies). In the IV trials, there was no significant difference in the incidence of CI-AKI using either definition (≧0.5 mg/dl definition: RR: 0.967, 95% CI: 0.188–4.972, p = 0.968, 3 trials; ≧25% definition: RR: 0.656, 95% CI: 0.316–1.360, p = 0.257, 4 trials). Conclusions: IA but not IV administration of iodixanol is associated with a significantly lower risk of CI-AKI than LOCM.

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Section: Discussionmentioning

confidence: 91%

Effects of Intra-Arterial and Intravenous Iso-Osmolar Contrast Medium (Iodixanol) on the Risk of Contrast-Induced Acute Kidney Injury: A Meta-Analysis

McCullough

Brown

2011

Cardiorenal Med

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“…For further analyses, the population was thus grouped according to (1) statin use, (2) high versus low LDL levels, (3) high versus low HDL levels, (4) high versus low triglyceride levels, and (5) high versus low LDL/HDL ratio. For LDL, the cut-off of 100 mg/dl was chosen according to current guidelines [10]. Since no thresholds for HDL, triglycerides and the LDL/HDL ratio have been reported in the literature, the population was split using the 25th (for HDL) and 75th (for triglycerides and LDL/HDL ratio) percentiles as cut-off values.…”

Section: Methodsmentioning

confidence: 99%

Impact of Statin Use and Lipid Profile on Symptomatic Intracerebral Haemorrhage, Outcome and Mortality after Intravenous Thrombolysis in Acute Stroke

et al. 2012

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Background: It is unclear if a certain lipid profile and/or statin use contribute to symptomatic intracerebral haemorrhage (sICH), poor outcome or mortality after intravenous thrombolysis for ischaemic stroke. The aim of the current study was to assess the impact of statin use and lipid profile on sICH, outcome and mortality following thrombolysis in acute stroke. Methods: From 2001 to 2010, all patients admitted to our hospital and undergoing intravenous thrombolysis for acute ischaemic stroke were included into an open, prospective database. Initial stroke severity was assessed using the National Institute of Health Stroke Scale. Demographics, vascular risk factors, admission blood pressure, glucose levels, previous medication including statin use, lipid profiles including low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride levels were recorded. Outcome measures included sICH according to the European Cooperative Acute Stroke Study II criteria, modified Rankin scale and mortality at 3 months. Results: 1,066 patients were included in the analysis; 5.3% (57 patients) had sICH. Mortality at 3 months was 17.6% (188 patients). A favourable outcome (modified Rankin scale 0–1) at 3 months was attained by 35.6% (379 patients). Prior statin use was not associated with increased odds for sICH (OR 1.05, 95% CI 0.55–2.04, p = 0.864), mortality (OR 1.32, 95% CI 0.90–1.93, p = 0.152) or favourable outcome (OR 0.89, 95% CI 0.65–1.24, p = 0.507). Similar results were found for the different lipid variables: high LDL (OR 0.96, 95% CI 0.36–2.60, p = 0.942), high triglyceride (OR 1.74, 95% CI 0.84–3.56, p = 0.132) and low HDL (OR 1.78, 95% CI 0.68–4.65, p = 0.279) were not associated with increased odds for sICH. Likewise, neither mortality nor functional outcome at 3 months was significantly associated with any of the lipid variables in the univariable analysis following Bonferroni adjustment for multiple comparisons. The same results were found in the multivariable analysis adjusting for imbalances in baseline characteristics. Conclusions: In contrast to previous studies, we found that in stroke patients receiving thrombolysis therapy, neither the lipid profile nor prior statin use were associated with increased odds for sICH, functional outcome or mortality at 3 months.

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“…The end point of this intervention is restoration of coronary blood flow. In the past, there had been a focus on achieving a door‐to‐balloon (D2B) time ≤90 minutes, ie, time of hospital arrival to primary PCI 3. D2B time has proven to be a fair metric, and strategies such as prehospital transmission of ECGs have been designed around meeting such a benchmark with moderate success 4, 5, 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Impact of Sex and Contact‐to‐Device Time on Clinical Outcomes in Acute ST‐Segment Elevation Myocardial Infarction—Findings From the National Cardiovascular Data Registry

Roswell

Kunkes

Chen

et al. 2017

JAHA

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BackgroundEmergent myocardial reperfusion via primary percutaneous coronary intervention is optimal care for patients presenting with ST‐segment elevation myocardial infarction (STEMI). Delays in such interventions are associated with increases in mortality. With the shift in focus to contact‐to‐device (C2D) time as a new perfusion metric, this study was designed to examine how sex affects C2D time and mortality in STEMI patients.Methods and ResultsClinical data on male and female STEMI patients were extracted and analyzed from the National Cardiovascular Data Registry from July 1, 2008 to December 31, 2014. A total of 102 515 patients were included in the final analytic cohort. The median C2D time in female patients with STEMI was delayed when compared to male patients (80 [65–97] versus 75 [61–90] minutes; P<0.001). The unadjusted mortality was higher in female patients when compared to male patients with STEMI (4.1% versus 2.0%; P<0.001). For every 5‐minute increase in C2D time, the adjusted odds ratio for mortality was 1.04 (95% CI, 1.03–1.06) for female patients with STEMI and 1.07 (95% CI, 1.06–1.09) for male patients (P for sex by C2D interaction=0.003).ConclusionsTo date, this is the largest analysis of STEMI patients that measures the impact of the new recommended C2D reperfusion metric on in‐hospital mortality. Female STEMI patients have longer C2D times and increased mortality. The disparity can be improved and survival can increase in this high‐risk patient cohort by decreasing systems issues that cause increased reperfusion times in female STEMI patients.

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2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Abstract: updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update): a report of the

Cited by 1,448 publications

References 155 publications

Effects of Intra-Arterial and Intravenous Iso-Osmolar Contrast Medium (Iodixanol) on the Risk of Contrast-Induced Acute Kidney Injury: A Meta-Analysis

Effects of Intra-Arterial and Intravenous Iso-Osmolar Contrast Medium (Iodixanol) on the Risk of Contrast-Induced Acute Kidney Injury: A Meta-Analysis

Impact of Statin Use and Lipid Profile on Symptomatic Intracerebral Haemorrhage, Outcome and Mortality after Intravenous Thrombolysis in Acute Stroke

Impact of Sex and Contact‐to‐Device Time on Clinical Outcomes in Acute ST‐Segment Elevation Myocardial Infarction—Findings From the National Cardiovascular Data Registry

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