2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST‐elevation myocardial Infarction: An update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST‐elevation myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions

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; Halperin, Jonathan L.; Anderson, Jeffrey L.; Albert, Nancy M.; Al‐Khatib, Sana M.; Birtcher, Kim K.; Bozkurt, Biykem; Cigarroa, Joaquin E.; Curtis, Lesley H.; Fleisher, Lee A.; Gentile, Federico; Gidding, Samuel S.; Mark, Daniel B.; Ikonomidis, John S.; Joglar, José A.; Kovacs, Richard J.; Ohman, E. Magnus; Pressler, Susan J.; Sellke, Frank W.; Shen, Win-Kuang; Wijeysundera, Duminda N.

doi:10.1002/ccd.26325

Cited by 84 publications

(22 citation statements)

References 40 publications

(50 reference statements)

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“…Although DAPT is recommended for up to 12 months after cardiac stent implantation, emergent surgical procedures, significant bleeding, or prolonged nothing by mouth status may result in oral DAPT interruption during this initial high‐risk time period. Clinicians must balance the risks of in‐stent thrombosis and recurrent myocardial infarction associated with oral DAPT withdrawal against the risks of surgical‐related bleeding with prolonged antiplatelet effects in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…Dual‐antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 platelet receptor inhibitor (e.g., clopidogrel, prasugrel, or ticagrelor) is recommended for up to 12 months and in some cases longer after cardiac stent implantation to prevent stent thrombosis and recurrent myocardial infarction . Interruption of DAPT for surgical procedures within the initial high‐risk 3‐ to 6‐month time frame after cardiac stent placement is associated with increased rates of ischemic complications.…”

mentioning

confidence: 99%

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Bridging with Tirofiban during Oral Antiplatelet Interruption: A Single‐Center Case Series Analysis Including Patients on Hemodialysis

Walker

Dager

2017

Pharmacotherapy

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Bridging with Tirofiban during Oral Antiplatelet Interruption: A Single‐Center Case Series Analysis Including Patients on Hemodialysis

Walker

Dager

2017

Pharmacotherapy

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“…Dual antiplatelet therapy, anticoagulation drugs, ACEI/ARB, statin, as well as β-blocker are the first-line drugs that recommended in treating STEMI in the guideline, which could improve the short- and long-term outcomes. [27]Nevertheless, compared with patients in the primary PCI group, these medications were less used in the fibrinolysis group and no reperfusion group. Age was not an contraindication for the antiplatelet drug.…”

Section: Discussionmentioning

confidence: 99%

The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI) Registry

Yang

Gao

et al. 2016

PLoS ONE

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BackgroundOnly a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI) patients (≥ 75 years old). Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population.MethodsBased on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared. The primary endpoint was defined as death. Secondary endpoints included recurrent myocardial infarction, ischemia driven revascularization, myocardial infarction related complications, and major bleeding. Multivariable regression analysis was performed to adjust for the baseline disparities between the groups.ResultsPatients who had primary percutaneous coronary intervention (PCI) or fibrinolysis were relatively younger. They came to hospital earlier, and had lower risk of death compared with patients who had no reperfusion. The guideline recommended medications were more frequently used in patients with primary PCI during the hospitalization and at discharge. The rates of death were 7.7%, 15.0%, and 19.9% respectively, with primary PCI, fibrinolysis, and no reperfusion (P < 0.001). Patients having primary PCI also had lower rates of heart failure, mechanical complications, and cardiac arrest compared with fibrinolysis and no reperfusion (P < 0.05). The rates of hemorrhage stroke (0.3%, 0.6%, and 0.1%) and other major bleeding (3.0%, 5.0%, and 3.1%) were similar in the primary PCI, fibrinolysis, and no reperfusion group (P > 0.05). In the multivariable regression analysis, primary PCI outweighs no reperfusion in predicting the in-hospital death in patients ≥ 75 years old. However, fibrinolysis does not.ConclusionsEarly reperfusion, especially primary PCI was safe and effective with absolute reduction of mortality compared with no reperfusion. However, certain randomized trials were encouraged to support the conclusion.

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“…Studies have shown an increase in short- and long-term mortality with progressive delays between symptom onset and PCI [25], where each 30-min delay from symptom onset was associated with around 8% increase in the relative risk of mortality at 1 year [26]. …”

Section: Discussionmentioning

confidence: 99%

Intracoronary Eptifibatide During Primary Percutaneous Coronary Intervention in Early Versus Late Presenters with ST Segment Elevation Myocardial Infarction: A Randomized Trial

et al. 2016

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IntroductionThe role of intracoronary (IC) eptifibatide in primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI) and whether time of patient presentation affects this role are unclear. We sought to evaluate the benefit of IC eptifibatide use during primary PCI in early STEMI presenters compared to late STEMI presenters.MethodsWe included 70 patients who presented with STEMI and were eligible for PPCI. On the basis of symptom-to-door time, patients were classified into two arms: early (<3 h, n = 34) vs late (≥3 h, n = 36) presenters. They were then randomized to local IC eptifibatide infusion vs standard care (control group). The primary end point was post-PCI myocardial blush grade (MBG) in the culprit vessel. Other end points included corrected TIMI frame count (cTFC), ST segment resolution (STR) ≥70%, and peak CKMB.ResultsIn the early presenters arm, no difference was observed in MBG results ≥2 in the IC eptifibatide and control groups (100% vs 82%; p = 0.23). In the late presenters arm, the eptifibatide subgroup was associated with improved MBG ≥2 (100% vs 50%; p = 0.001). IC eptifibatide in both early and late presenters was associated with less cTFC (early presenters 19 vs. 25.6, p = 0.001; late presenters 20 vs. 31.5, p < 0.001) and less peak CKMB (early presenters 210 vs 260 IU/L, p = 0.006; late presenters 228 vs 318 IU/L, p = 0.005) compared with the control group. No difference existed between both groups in STR index in early and late presenters.ConclusionIC eptifibatide might improve the reperfusion markers during PPCI for STEMI patients presenting after 3 h from onset of symptoms. A large randomized study is recommended to ascertain the benefits of IC eptifibatide in late presenters on clinical outcomes.

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Cited by 84 publications

References 40 publications

Bridging with Tirofiban during Oral Antiplatelet Interruption: A Single‐Center Case Series Analysis Including Patients on Hemodialysis

Bridging with Tirofiban during Oral Antiplatelet Interruption: A Single‐Center Case Series Analysis Including Patients on Hemodialysis

The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI) Registry

Intracoronary Eptifibatide During Primary Percutaneous Coronary Intervention in Early Versus Late Presenters with ST Segment Elevation Myocardial Infarction: A Randomized Trial

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