Academic literature on the topic 'Antithrombotic strategies, acute coronary syndrome, ST elevation acute myocardial infarction (STEMI), percutaneous coronary intervention'
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Journal articles on the topic "Antithrombotic strategies, acute coronary syndrome, ST elevation acute myocardial infarction (STEMI), percutaneous coronary intervention"
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Seker, Onur Osman, Idris Bugra Cerik, Metin Coksevim, Mustafa Yenercag, and Korhan Soylu. "Effectiveness of Different P2Y12 Inhibitors on Coronary Flow in Patients with ST-Elevation Myocardial Infarction." Journal Of Cardiovascular Emergencies 6, no. 4 (December 1, 2020): 91–97. http://dx.doi.org/10.2478/jce-2020-0018.
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Abstract Background: ST-segment elevation myocardial infarction (STEMI) is a clinical syndrome with high mortality. The main purpose of STEMI treatment is to achieve optimal revascularization for tissue perfusion. Besides the innovations in revascularization strategies, developments in antithrombotic therapy resulted in a significant reduction in STEMI-related mortality. Reperfusion can be demonstrated by resolution of ST-segment elevation (STR), TIMI frame count (TFC), and myocardial blush grade (MBG). Aim of the study: In our study, we investigated the effects of P2Y12 inhibitors clopidogrel, prasugrel, and ticagrelor on reperfusion parameters such as TFC, MBG, and STR, after primary percutaneous coronary intervention (pPCI) in STEMI. Material and Methods: The study was a retrospective analysis of STEMI patients who underwent successful pPCI. A total of 120 patients were included in the study as 3 equal groups according to the type of P2Y12 inhibitor administered in loading dose in the acute phase, and reperfusion parameters were compared between the groups. Results: There was no statistically significant difference between the groups in terms of baseline demographic, clinical, and angiographic parameters. Evaluation of reperfusion parameters indicated that STR, MBG, angina relief after pPCI and corrected TFC (cTFC) were significantly different between the groups (p <0.05). In post-hoc analysis, the percentage of change in STR, MBG, angina relief after pPCI, and cTFC was significantly higher in the prasugrel group (p <0.017). Conclusion: In STEMI patients undergoing pPCI, the analysis of tissue level reperfusion parameters indicates a superior effect of prasugrel compared with other P2Y12 inhibitors used to achieve reperfusion.
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Seker, Onur Osman, Idris Bugra Cerik, Metin Coksevim, Mustafa Yenercag, and Korhan Soylu. "Effectiveness of Different P2Y12 Inhibitors on Coronary Flow in Patients with ST-Elevation Myocardial Infarction." Journal Of Cardiovascular Emergencies 6, no. 4 (December 1, 2020): 91–97. http://dx.doi.org/10.2478/jce-2020-0018.
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AbstractBackground: ST-segment elevation myocardial infarction (STEMI) is a clinical syndrome with high mortality. The main purpose of STEMI treatment is to achieve optimal revascularization for tissue perfusion. Besides the innovations in revascularization strategies, developments in antithrombotic therapy resulted in a significant reduction in STEMI-related mortality. Reperfusion can be demonstrated by resolution of ST-segment elevation (STR), TIMI frame count (TFC), and myocardial blush grade (MBG). Aim of the study: In our study, we investigated the effects of P2Y12 inhibitors clopidogrel, prasugrel, and ticagrelor on reperfusion parameters such as TFC, MBG, and STR, after primary percutaneous coronary intervention (pPCI) in STEMI.Material and Methods: The study was a retrospective analysis of STEMI patients who underwent successful pPCI. A total of 120 patients were included in the study as 3 equal groups according to the type of P2Y12 inhibitor administered in loading dose in the acute phase, and reperfusion parameters were compared between the groups.Results: There was no statistically significant difference between the groups in terms of baseline demographic, clinical, and angiographic parameters. Evaluation of reperfusion parameters indicated that STR, MBG, angina relief after pPCI and corrected TFC (cTFC) were significantly different between the groups (p <0.05). In post-hoc analysis, the percentage of change in STR, MBG, angina relief after pPCI, and cTFC was significantly higher in the prasugrel group (p <0.017).Conclusion: In STEMI patients undergoing pPCI, the analysis of tissue level reperfusion parameters indicates a superior effect of prasugrel compared with other P2Y12 inhibitors used to achieve reperfusion.
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Kireyev, Dmitriy, Huay Cheem Tan, and Kian Keong Poh. "Management of Acute ST-Elevation Myocardial Infarction: Reperfusion Options." Annals of the Academy of Medicine, Singapore 39, no. 12 (December 15, 2010): 927–33. http://dx.doi.org/10.47102/annals-acadmedsg.v39n12p927.
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Primary percutaneous coronary intervention and thrombolysis remain therapies of choice for patients presenting with ST-segment elevation myocardial infarction (STEMI). Clinical outcome in the management of acute STEMI is dependent on myocardial reperfusion time and reperfusion strategies. Optimisation of these strategies should take into consideration logistical limitations of the local medical systems and the various patient profiles. We review the reperfusion strategies and its history in Singapore, comparing its clinical application with that in some developed Western countries. Key words: Acute Myocardial Infarction, Primary Percutaneous Coronary Intervention, ST segment Elevation Myocardial Infarction, Thrombolysis
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Vlachojannis, Georgios J., Bimmer E. Claessen, and George D. Dangas. "Early Stent Thrombosis after Percutaneous Coronary Intervention for Acute Myocardial Infarction." Interventional Cardiology Review 7, no. 1 (2012): 33. http://dx.doi.org/10.15420/icr.2012.7.1.33.
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Stent thrombosis (ST) is the most feared complication of coronary stent treatment because of its morbidity and mortality. Ongoing research is focusing on the frequency and the timing in various patient subsets as well as the factors associated with the occurrence of ST. The mechanism of ST is multifactorial, hence various procedure-, lesion- and patient-related factors have been associated with its occurrence. Beside these factors the role of adjunctive antithrombotic therapy remains unchallenged. Emerging data suggest that primary percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) can be a predictor of subsequent ST. As patients presenting with STEMI are at increased risk of ST, employment of the optimal pharmacological, procedure- and device-related prevention and treatment modalities are imperative.
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Kandan, Sri Raveen, and Thomas W. Johnson. "Contemporary Antiplatelet Strategies in the Treatment of STEMI using Primary Percutaneous Coronary Intervention." Interventional Cardiology Review 10, no. 1 (2015): 26. http://dx.doi.org/10.15420/icr.2015.10.1.26.
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Reperfusion therapy for patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PPCI) and concomitant oral antiplatelet and intravenous antithrombotic pharmacotherapy. There is a conflict between the desire to reduce the time between first medical contact and coronary re-canalisation and achieving effective platelet inhibition with oral antiplatelet agents. This review outlines the currently available antiplatelet treatments, and their place within the therapeutic timeline of a patient presenting with STEMI. Additionally, we focus on current challenges associated with effective antiplatelet treatment, including acute stent thrombosis (AST), the effect of morphine, platelet function assessment and concomitant anticoagulant therapy.
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Gilyarov, M. Yu, E. V. Konstantinova, M. R. Atabegashvili, T. D. Solntseva, D. A. Anichkov, А. N. Kostina, R. V. Polybin, A. E. Udovichenko, and A. V. Svet. "Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome." Rational Pharmacotherapy in Cardiology 17, no. 2 (May 7, 2021): 221–27. http://dx.doi.org/10.20996/1819-6446-2021-04-10.
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Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS.
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Thani, Khalid Bin, Fajer Al-Moosa, Eman Murad, Aisha Al-Moosa, Mohamed E. Alalawi, and Hind Al-Sindi. "Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction." Open Cardiovascular Medicine Journal 9, no. 1 (December 29, 2015): 127–32. http://dx.doi.org/10.2174/1874192401509010127.
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Main Problem:To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). Methods:An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI. Results:A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04). Conclusion:ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.
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Zeymer, Uwe, Peter Ludman, Nicolas Danchin, Petr Kala, Aldo P. Maggioni, Franz Weidinger, C. P. Gale, et al. "The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry." European Heart Journal - Quality of Care and Clinical Outcomes 6, no. 2 (July 30, 2019): 100–104. http://dx.doi.org/10.1093/ehjqcco/qcz042.
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Abstract Aims The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
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Fallahzadeh, Aida, Ali Sheikhy, Afsaneh Aein, Mojtaba Salarifar, Hamidreza Pourhosseini, Hassan Aghajani, Mohammad Alidoosti, Saeed Sadeghian, and Kaveh Hosseini. "Outcome of Percutaneous Coronary Intervention in Old Patients Presenting with Acute Coronary Syndrome." Archives of Iranian Medicine 25, no. 8 (August 1, 2022): 523–32. http://dx.doi.org/10.34172/aim.2022.84.
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Background: Octogenarians (age≥80 years) with coronary artery disease constitute a high-risk group and the elderly undergoing percutaneous coronary intervention (PCI) are at higher risk of adverse outcomes compared to young patients. In this study, we aimed to describe the outcomes of the elderly with acute coronary syndrome (ACS) who underwent PCI and also to identify the predictors of short-term major adverse cerebrocardiovascular events (MACCE) in octogenarians. Methods: In this registry-based cohort study, we reviewed the data of patients (aged≥65 years) who underwent PCI. Univariate Cox-regression model was used to assess the univariate effects of covariates on mortality and MACCE and multivariate Cox-regression analysis were used to discover MACCE predictors. Results: We reviewed the data of 3332 patients (2722 elderly [65 to 79 years], and 610 octogenarians [≥80 years]). The cumulative hazard of MACCE was significantly higher in the octogenarian group compared with the younger group (P<0.001). MACCE in octogenarians presenting with ST-elevation myocardial infarction (STEMI) was significantly higher than those with non-ST-elevation myocardial infarction/Unstable angina (NSTEMI/UA) (P<0.001); however, the cumulative hazard of mortality was not significantly different between the two groups (P=0.270). Successful PCI, left main stenosis and estimated glomerular filtration rate (eGFR) were independent predictors of MACCE in octogenarians with ACS. Conclusion: Octogenarians undergoing PCI had a higher rate of MACCE and mortality compared with a younger population. In octogenarians, MACCE in those with STEMI was significantly higher than those with NSTEMI/UA and the mortality trend was similar; however, the 1-year trend was in favor of the STEMI subgroup.
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Kedev, Sasko. "The Role of the Transradial Approach for Complex Coronary Interventions in Patients with Acute Coronary Syndrome." Interventional Cardiology Review 8, no. 2 (2013): 81. http://dx.doi.org/10.15420/icr.2013.8.2.81.
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Despite advances in antithrombotic and antiplatelet therapy, bleeding complications remain an important cause of morbidity and mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). A significant proportion of such bleedings are related to the access site, and adoption of transradial access (TRA) may reduce these complications. In patients with ST-segment elevation myocardial infarction (STEMI), TRA reduced cardiac mortality in comparison with the femoral approach (TFA). High-risk patients such as women, obese patients and elderly subjects who are at increased risk for vascular complications and bleeding, might particularly benefit from the TRA. However, specific radial expertise providing procedural time and a success rate comparable to those with the TFA are strongly recommended before using this technique in the emergency setting.
Dissertations / Theses on the topic "Antithrombotic strategies, acute coronary syndrome, ST elevation acute myocardial infarction (STEMI), percutaneous coronary intervention"
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Bellandi, Benedetta. "Pharmacodynamic of antithrombotic therapies in high cardiovascular risk patients." Doctoral thesis, 2018. http://hdl.handle.net/2158/1129305.
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This thesis addresses different aspects of antithrombotic strategies in patients with acute coronary syndrome, mainly in ST elevation acute myocardial infarction (STEMI) patients treated with percutaneous coronary intervention (PCI), regarding their efficacy and safety during the acute phase as well as their appropriateness and impact on long-term outcomes.
Books on the topic "Antithrombotic strategies, acute coronary syndrome, ST elevation acute myocardial infarction (STEMI), percutaneous coronary intervention"
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Sinnaeve, Peter, and Frans Van de Werf. Fibrinolytic, antithrombotic, and antiplatelet drugs in acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0044.
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Antithrombotic therapy is a major cornerstone in the treatment for acute coronary syndromes, as thrombus formation upon a plaque rupture or an erosion plays a pivotal role in non-ST-segment elevation as well as ST-segment elevation acute coronary syndromes. Both acute and long-term oral antiplatelet therapies, targeting specific platelet activation pathways, have demonstrated significant short- and long-term benefits. The use of anticoagulants is currently largely confined to the acute setting, except in patients with a clear indication for long-term treatment, including atrial fibrillation or the presence of intraventricular thrombi. Despite the benefit of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction, fibrinolysis continues to play an important role throughout the world as well. In this chapter, the fibrinolytic, antiplatelet, and anticoagulant agents used in the management of acute coronary syndrome patients are discussed.
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Sinnaeve, Peter, and Frans Van de Werf. Fibrinolytic, antithrombotic, and antiplatelet drugs in acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0044_update_001.
Full textAbstract:
Antithrombotic therapy is a major cornerstone in the treatment for acute coronary syndromes, as thrombus formation upon a plaque rupture or an erosion plays a pivotal role in non-ST-segment elevation as well as ST-segment elevation acute coronary syndromes. Both acute and long-term oral antiplatelet therapies, targeting specific platelet activation pathways, have demonstrated significant short- and long-term benefits. The use of anticoagulants is currently largely confined to the acute setting, except in patients with a clear indication for long-term treatment, including atrial fibrillation or the presence of intraventricular thrombi. Despite the benefit of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction, fibrinolysis continues to play an important role throughout the world as well. In this chapter, the fibrinolytic, antiplatelet, and anticoagulant agents used in the management of acute coronary syndrome patients are discussed.
Book chapters on the topic "Antithrombotic strategies, acute coronary syndrome, ST elevation acute myocardial infarction (STEMI), percutaneous coronary intervention"
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Prasad, Abhiram, and Claire Raphael. "Acute coronary syndrome: STEMI and NSTEMI." In The ESC Handbook on Cardiovascular Pharmacotherapy, edited by Alexander Niessner, Sven Wassmann, and Udo Sechtem, 71–90. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198759935.003.0005.
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Management of acute coronary syndrome (ACS) is dictated by clinical features and electrocardiographic findings. Morphine is used for pain relief. Sublingual or intravenous nitrates are administered to relieve ischaemia. Patients should be loaded with dual antiplatelet medications, usually aspirin and one of clopidogrel, prasugrel, or ticagrelor. For ST-segment elevation myocardial infarction, reperfusion therapy is with primary percutaneous coronary intervention (PPCI) or thrombolysis for those presenting to non-PPCI centres who cannot have timely access to PPCI. For non-ST-segment elevation myocardial infarction and unstable angina, timing of angiography, and revascularization if indicated, is determined by the severity of ischaemia. All patients with ACS should be treated with secondary prevention medications, including antiplatelet therapy, statins, beta-blockers, and renin–angiotensin system inhibitors.
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Prasad, Abhiram, and Claire Raphael. "Acute coronary syndrome: STEMI and NSTEMI." In The ESC Handbook on Cardiovascular Pharmacotherapy, edited by Alexander Niessner, Sven Wassmann, and Udo Sechtem, 71–90. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198759935.003.0005_update_001.
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Management of acute coronary syndrome (ACS) is dictated by clinical features and electrocardiographic findings. Morphine is used for pain relief. Sublingual or intravenous nitrates are administered to relieve ischaemia. Patients should be treated with dual antiplatelet medications, usually aspirin and one of clopidogrel, prasugrel, or ticagrelor. For ST-segment elevation myocardial infarction, reperfusion therapy is with primary percutaneous coronary intervention (PPCI) or thrombolysis for those presenting to non-PPCI centres who cannot have timely access to PPCI. For non-ST-segment elevation myocardial infarction and unstable angina, timing of angiography, and revascularization if indicated, is determined by the severity of ischaemia. All patients with ACS should be treated with secondary prevention medications, including antiplatelet therapy, statins, beta-blockers, and renin–angiotensin system inhibitors.
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Becker, Richard C., and Frederick A. Spencer. "Acute Coronary Syndromes." In Fibrinolytic and Antithrombotic Therapy. Oxford University Press, 2006. http://dx.doi.org/10.1093/oso/9780195155648.003.0025.
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For over a century astute clinicians have recognized that prodromal symptoms often precede acute myocardial infarction (MI). The evolution of symptoms was subsequently found to correlate with changes in atherosclerotic plaque composition, morphology, and thrombogenicity, leading to the classification of symptoms that are currently categorized to better delineate diagnostic and management strategies. Acute coronary syndromes (ACSs) are traditionally divided into two separate categories—ST-segment elevation and non–ST-segment elevation ACS—based on the presenting electrocardiogram. The latter category is then subdivided into unstable angina and non–ST-segment elevation MI, based on the absence or presence of elevated cardiac biomarkers, respectively. This chapter considers ST-segment elevation MI and non–ST-segment elevation ACS based on pharmacologic and clinical (diagnostics and routine management) constructs. ST-segment elevation MI (STEMI), in a vast majority of cases, is caused by occlusive thrombosis at a site of plaque rupture. In others, particularly when the stimulus for thrombosis is strong, occlusion may follow minor disruption of the plaque surface (erosion) or occur in areas of endothelial cell injury (activation with inflammatory features and concomitantly impaired vascular thromboresistance). Coronary arterial spasm, in the absence of intrinsic vascular disease (as may be seen with cocaine use), can also impair restrictive blood flow to the myocardium, resulting in cellular death. The goal of pharmacology-based therapy (and mechanical intervention) is to restore myocardial blood flow as quickly and completely as possible. The “open vessel hypotheses” predicts that rapid, complete, and sustained myocardial perfusion through the prompt restoration of physiologic blood flow will minimize (salvage) myocardium, promote ventricular performance, and reduce mortality. Strong support for the open-vessel hypothesis can be traced to the Thrombolysis and Myocardial Infarction (TIMI) trial performed in the 1980s (Dalen et al., 1988; TIMI Study Group, 1985). Patients with patent infarct-related coronary arteries 90 minutes after the initiation of fibrinolytic therapy had an 8.1% mortality at 1 year, compared to a 14.8% mortality among those with an occluded vessel. Since that time, several large-scale clinical trials have confirmed the importance of an open infarct-related coronary artery for early, intermediate, and long-term outcome.
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Mahmoudi, Michael, and Nick Curzen. "Percutaneous coronary intervention in non-ST elevation acute coronary syndrome." In Oxford Textbook of Interventional Cardiology, 234–53. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199569083.003.015.
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Ischaemic heart disease (IHD) accounts for 30% of all deaths in men and 25% of all deaths in women in England and Wales. IHD also remains the commonest cause of death in many industrialized countries. The current global impact of IHD is one of marked contrasts. Many countries with previously high rates of IHD, including the United Kingdom, United States, and Finland, are experiencing declines whereas the rates of IHD are rising in many countries such as central and eastern Europe where the rates were previously ‘low’. The annual incidence of non-ST elevation acute coronary syndrome (NSTEACS) has been estimated at approximately three per 1000 populations. Hospital mortality is greater than in those patients presenting with ST-elevation myocardial infarction (STEMI) (7% vs. 5%), although at 6 months, the mortality rates become similar.
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Ramrakha, Punit S., Kevin P. Moore, and Amir H. Sam. "Cardiac emergencies." In Oxford Handbook of Acute Medicine, 1–170. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198797425.003.0001.
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This chapter describes cardiac emergencies, including adult life support (basic and advanced), universal treatment algorithm, acute coronary syndrome (ACS), ST-elevation myocardial infarction (STEMI; diagnosis, general measures, reperfusion therapy, thrombolysis, reperfusion by primary percutaneous coronary intervention (PCI), surgery, predischarge risk stratification, complications), ventricular septal defect post-myocardial infarction (MI), atrial tachyarrhythmia post-MI, bradyarrhythmias and indications for pacing, hypotension and shock post-MI, cardiogenic shock, non-ST-elevation MI (NSTEMI; diagnosis, risk stratification, medical management, invasive and non-invasive strategies, discharge, and secondary prevention), arrhythmias, tachyarrhythmias, tachycardia (broad complex, monomorphic, polymorphic, ventricular, narrow complex), atrial fibrillation (AF), atrial flutter, multifocal atrial tachycardia (MAT), accessory pathway tachycardia, atriventricular nodal re-entry tachycardia (AVNRT), bradyarrhythmias, sinus bradycardia, intraventricular conduction disturbances, pulmonary oedema, endocarditis (infective, culture-negative, right-sided, prosthetic valve, prophylaxis), acute aortic regurgitation (AR), acute mitral regurgitation (MR), deep vein thrombosis (DVT), pulmonary embolism (PE), fat embolism, hypertensive emergencies, hypertensive encephalopathy, aortic dissection, acute pericarditis, bacterial pericarditis, cardiac tamponade, and congenital heart disease in adults.
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Halvorsen, Sigrun, Giuseppe Gargiulo, Marco Valgimigli, and Kurt Huber. "Fibrinolytic, antiplatelet, and anticoagulant drugs in acute coronary syndromes." In The ESC Textbook of Intensive and Acute Cardiovascular Care, edited by Marco Tubaro, Pascal Vranckx, Eric Bonnefoy-Cudraz, Susanna Price, and Christiaan Vrints, 494–512. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849346.003.0040.
Full textAbstract:
Antithrombotic therapy is a major cornerstone in the treatment of acute coronary syndromes (ACS), as thrombus formation upon a plaque rupture or an erosion plays a pivotal role in non-ST-segment elevation as well as ST-segment elevation acute coronary syndromes. Both acute and long-term oral antiplatelet therapies, targeting specific platelet activation pathways, have demonstrated significant short- and long-term benefits. The use of anticoagulants is currently largely confined to the acute setting, except in patients with a clear indication for long-term treatment, including atrial fibrillation or the presence of intraventricular thrombi. Despite the benefit of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction, fibrinolytic therapy continues to play an important role throughout the world. In this chapter, the fibrinolytic, antiplatelet, and anticoagulant agents used in the management of acute coronary syndrome patients are discussed.
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Waldmann, Carl, Andrew Rhodes, Neil Soni, and Jonathan Handy. "Cardiovascular disorders." In Oxford Desk Reference: Critical Care, 313–40. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198723561.003.0019.
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This chapter discusses cardiovascular disorders and includes discussion on hypertension (including discussion treatment of uncomplicated essential hypertension, management of hypertension in different patient groups, diabetes mellitus, ethnic groups, hypertensive crises, management of hypertensive emergencies, aortic dissection, acute pulmonary oedema, ST-elevation myocardial infarction (STEMI) and acute coronary syndrome, cocaine overdose, severe pre-eclampsia and eclampsia, malignant hypertension, hypertensive encephalopathy, stroke, and drugs for the treatment of hypertensive emergencies). It also covers tachyarrhythmias (especially common pathological arrhythmias and management), bradyarrhythmias (including the causes thereof, sinus node dysfunction, atrioventricular conduction disturbance, clinical approach, pharmacotherapy, and pacing), and myocardial infarction diagnosis (describing the diagnostic tools). Non-STEMI (differential diagnoses, risk assessment, management, anti-ischaemic therapy, withdrawal of dual antiplatelet therapy, lipid-lowering therapy, and invasive versus conservative management) and STEMI (diagnosis, initial evaluation in the emergency department, prehospital care, reperfusion strategy, primary percutaneous coronary intervention, periprocedural pharmacotherapy, and structural issues after STEMI) are also discussed, as are acute heart failure (both assessment and management) and bacterial endocarditis.