2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction

Levine, Glenn N.; Bates, Eric R.; Blankenship, James C.; Bailey, Steven R.; Bittl, John A.; Cercek, Bojan; Chambers, Charles E.; Ellis, Stephen G.; Guyton, Robert A.; Hollenberg, Steven M.; Khot, Umesh N.; Lange, Richard A.; Mauri, Laura; Mehran, Roxana; Moussa, Issam; Mukherjee, Debabrata; Ting, Henry H.; O’Gara, Patrick T.; Kushner, Frederick G.; Ascheim, Deborah D.; Brindis, Ralph G.; Casey, Donald E.; Chung, Mina K.; Lemos, James A. de; Diercks, Deborah B.; Fang, James C.; Franklin, Barry A.; Granger, Christopher B.; Krumholz, Harlan M.; Linderbaum, Jane A.; Morrow, David A.; Newby, L. Kristin; Ornato, Joseph P.; Ou, Narith N.; Radford, Martha J.; Tamis‐Holland, Jacqueline E.; Tommaso, Carl L.; Tracy, Cynthia M.; Woo, Y. Joseph; Zhao, David

doi:10.1016/j.jacc.2015.10.005

Cited by 688 publications

(186 citation statements)

References 37 publications

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“…Our study reinforces the need for more attention to be directed to patients who develop CS in the prehospital setting in clinical guidelines, research, and clinical practice and emphasis placed on the more‐aggressive use of early revascularization in these high‐risk patients 26, 27, 28, 29, 30, 31. The use of IABP is recommended,31, 32 and although newer interventional devices have provided better hemodynamic support than the use of conventional IABP, none of these devices have yet been shown to favorably improve survival compared with the use of IABP 33, 34…”

Section: Discussionsupporting

confidence: 73%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

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BackgroundCardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population‐based perspective. Our study objectives were to describe decade‐long trends in the incidence, in‐hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) ≥24 hours after hospitalization (late CS).Methods and ResultsThe study population consisted of 5782 patients with an acute myocardial infarction who were admitted to all 11 hospitals in central Massachusetts on a biennial basis between 2001 and 2011. The overall proportion of patients who developed CS was 5.2%. The proportion of patients with prehospital CS (1.6%) and late CS (1.5%) remained stable over time, whereas the proportion of patients with early CS declined from 2.2% in 2001–2003 to 1.2% in 2009–2011. In‐hospital mortality for prehospital CS increased from 38.9% in 2001–2003 to 53.6% in 2009–2011, whereas in‐hospital mortality for early and late CS decreased over time (35.9% and 64.7% in 2001–2003 to 15.8% and 39.1% in 2009–2011, respectively).ConclusionsDevelopment of prehospital and in‐hospital CS was associated with poor short‐term survival and the in‐hospital death rates among those with prehospital CS increased over time. Interventions focused on preventing or treating prehospital and late CS are needed to improve in‐hospital survival after acute myocardial infarction.

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Section: Discussionsupporting

confidence: 73%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

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“…However, most recently randomized clinical trials showed limited clinical benefit of routine manual thrombectomy [10–12, 22]. Consequently, recommendation of routine manual thrombectomy was downgraded [23]. The reason why thrombus aspiration results in conflicting data on myocardial reperfusion, infarct size, and clinical outcomes remains incompletely clear.…”

Section: Discussionmentioning

confidence: 99%

Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention

Tian

Liu

Song

et al. 2016

BioMed Research International

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Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI) thrombus grade 4~5 were eventually involved in our study. According to a cTFC value, patients were divided into Group I (cTFC > 40), namely, insufficient reperfusion group; Group II (cTFC ≤ 40), namely, sufficient reperfusion group. Results. Univariate analysis showed that hypertension, multivessel disease, time from symptom to PCI (≧4.8 hours), and postaspiration cTFC > 40 were negative predictors for insufficient reperfusion. After multivariate adjustment, age ≧ 60 years, hypertension, time from symptom to PCI (≧4.8 hours), and postaspiration cTFC > 40 were independently associated with insufficient reperfusion in STEMI patients treated with manual aspiration thrombectomy. Upfront intracoronary GP IIb/IIIa inhibitor (Tirofiban) was positively associated with improved myocardial reperfusion. Conclusion. Fully identifying risk factors will help to improve the effectiveness of selective thrombus aspiration.

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“…In STEMI(49, 50) and NSTE-ACS(51) primary percutaneous intervention is not controversial, with multiple studies demonstrating the efficacy of primary PCI in those settings. Nor should it be controversial in STEMI and NSTE-ACS patients with FH.…”

Section: Interventional Cardiology Of Fh: Unanswered Questionsmentioning

confidence: 99%

Percutaneous Coronary Intervention in Familial Hypercholesterolemia Is Understudied

Ungar

Sanders

Becerra

et al. 2018

Front. Cardiovasc. Med.

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Familial hypercholesterolemia (FH) is a common heritable condition in which mutations of genes governing cholesterol metabolism result in elevated LDL levels and accelerated atherosclerosis. The treatment of FH focuses on lipid lowering drugs to decrease patients' cholesterol levels and reduce their risk of cardiovascular events. Even with optimal medical therapy, some FH patients will develop coronary atherosclerosis, suffer myocardial infarction, and require revascularization. Yet, the revascularization of FH patients has not been widely studied. Here we review FH, identify unanswered questions in the interventional management of FH patients, and explore barriers and opportunities for answering these questions. Further research is needed in this neglected but important topic in interventional cardiology.

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2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction

Cited by 688 publications

References 37 publications

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention

Percutaneous Coronary Intervention in Familial Hypercholesterolemia Is Understudied

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