CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018

Abstract

While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI.

Cardiovascular events associated with nicorandil administration prior to primary percutaneous coronary intervention in patients with acute ST-segment elevated myocardial infarction: a systematic review and meta-analysis

“…Nicorandil, a hybrid K + -adenosine triphosphate (ATP) channel-opener and nitric-oxide releaser, has known cardioprotective effects and is recommended for use in angina [12] to improve slow flow or no-reflow phenomena during PCI [34]. In recent years, the use of nicorandil has decreased, largely MACE major adverse cardiovascular events;…”

Diurnal Variation in Outcomes of Percutaneous Coronary Intervention

“…Percutaneous coronary intervention is a common cardiovascular procedure [2]. Primary percutaneous coronary intervention, a mechanical intervention that enables restoration of blood flow by reopening the occluded artery via a catheter with an inflatable balloon, is currently the preferred reperfusion option for acute myocardial infarction with STsegment elevation [3].…”

The Comparison of Clinical Outcomes Between Inferior ST-Elevation Myocardial Infarction with Right Ventricular Infarction Versus Without Right Ventricular Infarction

“…Moreover, contemporary primary PCI is significantly different from earlier primary PCI in stent type, aspiration device, and imaging device, especially in Japan. 5) Thus, the research on the clinical outcomes of RVI in contemporary primary PCI era is sparse. The aim of the present study was to investigate the clinical outcomes of RVI in the contemporary primary PCI era.…”