2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Ibáñez, Borja; James, Stefan; Agewall, Stefan; Antunes, Manuel J.; Bucciarelli-Ducci, Chiara; Bueno, Héctor; Caforio, Alida L.P.; Crea, Filippo; Goudevenos, John; Halvorsen, Sigrun; Hindricks, Gerhard; Kastrati, Adnan; Lenzen, Mattie J.; Prescott, Eva; Roffi, Marco; Valgimigli, Marco; Varenhorst, Christoph; Vranckx, Pascal; Widimský, Petr

doi:10.1016/j.rec.2017.11.010

Cited by 353 publications

(430 citation statements)

References 452 publications

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“…Guidelines published in the last 2 years have suggested that the patients with ACS who are most likely to benefit from beta‐blockers in the contemporary pharmacological and reperfusion era are those with a left ventricular ejection fraction (LVEF) ≤ 40%, while others have continued to recommend beta‐blockers for all patients with ACS provided there are no contraindications to their use. In the absence of detailed clinical information, we cannot comment on the use of beta‐blockers in relation to LVEF in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical guidelines in New Zealand and elsewhere have recommended the use of beta‐blockers following MI to prevent further acute coronary events and death. In the past decade, New Zealand guidelines for primary care physicians have advised that ‘all people post‐MI or angina should be on aspirin, a statin and a beta‐blocker and considered for an ACE inhibitor, unless contraindicated’ and that beta‐blockers should also be used for patients with left ventricular dysfunction and heart failure…”

Section: Introductionmentioning

confidence: 99%

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Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

et al. 2019

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Background and objective Clinical guidelines recommend the use of beta‐blockers and other cardiovascular prevention drugs in patients with acute coronary syndrome (ACS). Studies in several countries have found that beta‐blockers are underused in patients with chronic obstructive pulmonary disease (COPD) and co‐morbid heart disease, although most have only examined use in subgroups of patients. We undertook a nationwide follow‐up study in New Zealand to describe the use of beta‐blockers and other cardiovascular prevention drugs in patients with COPD and ACS. Methods National health and pharmaceutical dispensing data were used to derive the study cohort, identify patients who were admitted to hospital with ACS and/or heart failure before cohort entry and during follow‐up, and ascertain drug use. Results The study cohort included 83 435 patients aged ≥45 years, with 290 400 person‐years of follow‐up. Among 2637 patients with ≥1 ACS admission during follow‐up, only 56.6% received a beta‐blocker in the 6 months following the first admission, while 87.7% and 81%, respectively, received aspirin and a statin. Patients with higher COPD severity were less likely to receive a beta‐blocker than those with lower severity, as were those with no history of previous ACS and/or heart failure. Conclusion Use of beta‐blockers following an ACS admission was much lower than expected based on the findings of general audits of ACS management in New Zealand. Along with the higher proportions using aspirin and statins, and the differences in beta‐blocker dispensing by COPD severity, this suggests a particular reluctance to prescribe beta‐blockers to patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

et al. 2019

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“…Immediate revascularization is recommended in all patients presenting angina signs ≤12 h and ST segment elevation [1]. VSD is a rare but catastrophic complication of acute MI.…”

Section: Discussionmentioning

confidence: 99%

Coincident Detection and Concomitant Repair of a Ventricular Septal Defect during Emergency Coronary Artery Bypass Grafting and Left Ventricular Aneurysm Resection

Mogaldea¹,

Ruemke²,

Haverich³

et al. 2018

Case Rep Acute Med

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This case report presents an accidental detection of a post-infarct ventricular septal defect (VSD) by a patient undergoing emergent coronary artery bypass grafting and left ventricular aneurysm resection. Both myocardial lesions were repaired simultaneously through the left ventricular aneurysm. The patient’s postoperative course was uneventful. This case shows the importance of intraoperative transesophageal echocardiography, as well as inspection of the interventricular septum, in an emergency setting to detect possible infarct VSDs.

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“…Many major risk factors of CAD have been known since the 1960s 7 , and cholesterol levels and smoking have since been targeted successfully in the population. The pharmaceutical industry developed antithrombotic agents (antiplatelet and anticoagulant drugs), which together with early revascularization resulted in improved and standardized cardiac care and reduced CAD morbidity and mortality 8–10 . However, the incidence of CAD has since remained relatively stable in higher income countries, and is now increasing rapidly in lower- and middle-income countries, as a result of increasingly unhealthy lifestyles 11 .…”

Section: Introductionmentioning

confidence: 99%

Zebrafish larvae as a model system for systematic characterization of drugs and genes in dyslipidemia and atherosclerosis

Bandaru

Emmanouilidou

Heyde

et al. 2018

Preprint

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Background Hundreds of loci have been robustly associated with circulating lipids, atherosclerosis and coronary artery disease; but for most loci the causal genes and mechanisms remain uncharacterized. Methods We developed a semi-automated experimental pipeline for systematic, quantitative, large-scale characterization of mechanisms, drugs and genes associated with dyslipidemia and atherosclerosis in a zebrafish model system. We validated our pipeline using a dietary (n>2000), drug treatment (n>1000), and genetic intervention (n=384), and used it to characterize three candidate genes in a GWAS-identified pleiotropic locus on chr 19p13.11 (n>500). Results Our results show that five days of overfeeding and cholesterol supplementation had independent pro-atherogenic effects, which could be diminished by concomitant treatment with atorvastatin and ezetimibe. CRISPR-Cas9-induced mutations in orthologues of proof-of-concept genes resulted in higher LDL cholesterol levels (apoea), and more early stage atherosclerosis (apobb.1). Finally, our pipeline helped identify putative causal genes for circulating lipids and early-stage atherosclerosis (LPAR2 and GATAD2A). Conclusions In summary, our pipeline facilitates systematic, in vivo characterization of drugs and candidate genes to increase our understanding of disease etiology, and can likely help identify novel targets for therapeutic intervention.

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2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Cited by 353 publications

References 452 publications

Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

Underuse of beta‐blockers by patients with COPD and co‐morbid acute coronary syndrome: A nationwide follow‐up study in New Zealand

Coincident Detection and Concomitant Repair of a Ventricular Septal Defect during Emergency Coronary Artery Bypass Grafting and Left Ventricular Aneurysm Resection

Zebrafish larvae as a model system for systematic characterization of drugs and genes in dyslipidemia and atherosclerosis

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