management of st-elevation myocardial infarction according to european and american guidelines
Post on 22-Dec-2015
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Management of ST-elevation myocardial
infarction according to European and American
guidelines
comparison of guidlines ESC 2012 and ACCF/AHAterms of class of recommendation level of evidence
main common recommendations
PCI-capable centre with symptom duration <12 h => <90 min
non-PCI centre<120 min
culprit lesion (except cardiogenic shock)
radial approach ; thrombus aspiration; DES implantation
prasugrel or ticagrelor preferred over clopidogrel
During PCI bivalirudin and unfractioned heparin indicated <-> fondaparinux contraindicated
dual antiplatelet therapy 12 monthsBMS 1 monthDES 6 months
fibrinolysisPCI not possible large infarctPCI in >90
coronary angiography within 3-24 h
post-discharge optimising coronary risk factor control smoke cessation rehabilitation programmes
medication DAPT 12 month beta-blockers ACE /ARB inhibitors statins: LDL < 70 mg/dl aldosterone inhibitors : left ventricular dysfunction Anticoagulation: left ventricular disfunction, atrial
fibrillation
Differences
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