ST elevation myocardial infarction management of patients who were not reperfused
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Directions to Hospitals Treating ST elevation myocardial infarction |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor-In-Chief:; Cafer Zorkun, M.D., Ph.D. [2]
Overview
STEMI patients who do not receive reperfusion therapy can be stratified for a differed mortality risk than those who do. The ACC/AHA guidelines recommend specific guidelines for care in this patient population.
Clinical Trial Data
![[1]](/index.php/File:FibrinolyticTxvsNoRep.jpg)
Adjusted probability of death or cerebral bleeding in relation to fibrinolytic therapy in patients with ST elevation myocardial infarction (STEMI) who were 75 years or older (dotted line) versus that among patients with STEMI not receiving fibrinolysis (solid line). At 30 days and 1 year this was 23% and 32% versus 26% and 36%, respectively.
2013 Revised ACCF/AHA Guidelines for the Management of ST-Elevation Myocardial Infarction (DO NOT EDIT)[2]
PCI of an Infarct Artery in Patients Who Initially Were Managed With Fibrinolysis or Who Did Not Receive Reperfusion Therapy (DO NOT EDIT)[2]
| Class I |
| "1. PCI of an anatomically significant stenosis in the infarct artery should be performed in patients with suitable anatomy and any of the following: |
| "a. Cardiogenic shock or acute severe HF[3](Level of Evidence: B)" |
| "b. Intermediate- or high-risk findings on predischarge noninvasive ischemia testing[4][5](Level of Evidence: C)" |
| "c. Myocardial ischemia that is spontaneous or provoked by minimal exertion during hospitalization.(Level of Evidence: C)" |
| Class III (No Benefit) |
| "1. Delayed PCI of a totally occluded infarct artery greater than 24 hours after STEMI should not be performed in asymptomatic patients with 1- or 2-vessel disease if they are hemodynamically and electrically stable and do not have evidence of severe ischemia.[6][7] (Level of Evidence: B)" |
| Class IIa |
| "1. Delayed PCI is reasonable in patients with STEMI and evidence of failed reperfusion or reocclusion after fibrinolytic therapy. PCI can be performed as soon as logistically feasible at the receiving hospital.[8][9][10][11](Level of Evidence: B)" |
| "2. Delayed PCI of a significant stenosis in a patent infarct artery is reasonable in stable§ patients with STEMI after fibrinolytic therapy. PCI can be performed as soon as logistically feasible at the receiving hospital, and ideally within 24 hours, but should not be performed within the first 2 to 3 hours after administration of fibrinolytic therapy.[12][13][14][15][16][17] |
2007 Focused Update of the ACCF/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention (DO NOT EDIT)[18]
PCI After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion (DO NOT EDIT)[18]
| Class I |
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"1. In patients whose anatomy is suitable, PCI should be performed when there is objective evidence of recurrent MI. (Level of Evidence: C)" |
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"2. In patients whose anatomy is suitable, PCI should be performed for moderate or severe spontaneous or provocable myocardial ischemia during recovery from STEMI.(Level of Evidence: B)" |
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"3. In patients whose anatomy is suitable, PCI should be performed for cardiogenic shock or hemodynamic instability. (Level of Evidence: B) |
| Class III |
| "1. PCI of a totally occluded infarct artery greater than 24 hours after STEMI is not recommended in asymptomatic patients with 1- or 2-vessel disease if they are hemodynamically and electrically stable and do not have evidence of severe ischemia. (Level of Evidence: B)" |
| Class IIa |
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"1. It is reasonable to perform routine PCI in patients with LV ejection fraction less than or equal to 0.40, heart failure, or serious ventricular arrhythmias. (Level of Evidence: C)" |
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"2. It is reasonable to perform PCI when there is documented clinical heart failure during the acute episode, even though subsequent evaluation shows preserved LV function (LV ejection fraction greater than 0.40). (Level of Evidence: C)" |
| Class IIb |
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"1. PCI might be considered as part of an invasive strategy after fibrinolytic therapy. (Level of Evidence: C)" |
Sources
- The 2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction [19]
- The 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction [20]
Related Chapters
- The STEMI Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines
References
- ↑ Stenestrand U, Wallentin L (2003). "Fibrinolytic therapy in patients 75 years and older with ST-segment-elevation myocardial infarction: one-year follow-up of a large prospective cohort". Arch. Intern. Med. 163 (8): 965–71. doi:10.1001/archinte.163.8.965. PMID 12719207. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 O'Gara PT, Kushner FG, Ascheim DD; et al. (2012). "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e3182742c84. PMID 23247303. Unknown parameter
|month=ignored (help) - ↑ Hochman JS, Sleeper LA, White HD; et al. (2001). "One-year survival following early revascularization for cardiogenic shock". JAMA. 285 (2): 190–2. PMID 11176812. Unknown parameter
|month=ignored (help) - ↑ Erne P, Schoenenberger AW, Burckhardt D; et al. (2007). "Effects of percutaneous coronary interventions in silent ischemia after myocardial infarction: the SWISSI II randomized controlled trial". JAMA. 297 (18): 1985–91. doi:10.1001/jama.297.18.1985. PMID 17488963. Unknown parameter
|month=ignored (help) - ↑ Madsen JK, Grande P, Saunamäki K; et al. (1997). "Danish multicenter randomized study of invasive versus conservative treatment in patients with inducible ischemia after thrombolysis in acute myocardial infarction (DANAMI). DANish trial in Acute Myocardial Infarction". Circulation. 96 (3): 748–55. PMID 9264478. Unknown parameter
|month=ignored (help) - ↑ Hochman JS, Lamas GA, Buller CE; et al. (2006). "Coronary intervention for persistent occlusion after myocardial infarction". N. Engl. J. Med. 355 (23): 2395–407. doi:10.1056/NEJMoa066139. PMC 1995554. PMID 17105759. Unknown parameter
|month=ignored (help) - ↑ Ioannidis JP, Katritsis DG (2007). "Percutaneous coronary intervention for late reperfusion after myocardial infarction in stable patients". Am. Heart J. 154 (6): 1065–71. doi:10.1016/j.ahj.2007.07.049. PMID 18035076. Unknown parameter
|month=ignored (help) - ↑ Sutton AG, Campbell PG, Graham R; et al. (2004). "A randomized trial of rescue angioplasty versus a conservative approach for failed fibrinolysis in ST-segment elevation myocardial infarction: the Middlesbrough Early Revascularization to Limit INfarction (MERLIN) trial". J. Am. Coll. Cardiol. 44 (2): 287–96. doi:10.1016/j.jacc.2003.12.059. PMID 15261920. Unknown parameter
|month=ignored (help) - ↑ Gibson CM, Murphy SA, Rizzo MJ; et al. (1999). "Relationship between TIMI frame count and clinical outcomes after thrombolytic administration. Thrombolysis In Myocardial Infarction (TIMI) Study Group". Circulation. 99 (15): 1945–50. PMID 10208996. Unknown parameter
|month=ignored (help) - ↑ Gibson CM, Cannon CP, Murphy SA, Marble SJ, Barron HV, Braunwald E (2002). "Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to long-term outcomes after thrombolytic administration in acute myocardial infarction". Circulation. 105 (16): 1909–13. PMID 11997276. Unknown parameter
|month=ignored (help) - ↑ Sutton AG, Campbell PG, Price DJ; et al. (2000). "Failure of thrombolysis by streptokinase: detection with a simple electrocardiographic method". Heart. 84 (2): 149–56. PMC 1760890. PMID 10908249. Unknown parameter
|month=ignored (help) - ↑ Bøhmer E, Hoffmann P, Abdelnoor M, Arnesen H, Halvorsen S (2010). "Efficacy and safety of immediate angioplasty versus ischemia-guided management after thrombolysis in acute myocardial infarction in areas with very long transfer distances results of the NORDISTEMI (NORwegian study on DIstrict treatment of ST-elevation myocardial infarction)". J. Am. Coll. Cardiol. 55 (2): 102–10. doi:10.1016/j.jacc.2009.08.007. PMID 19747792. Unknown parameter
|month=ignored (help) - ↑ Borgia F, Goodman SG, Halvorsen S; et al. (2010). "Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis". Eur. Heart J. 31 (17): 2156–69. doi:10.1093/eurheartj/ehq204. PMID 20601393. Unknown parameter
|month=ignored (help) - ↑ Cantor WJ, Fitchett D, Borgundvaag B; et al. (2009). "Routine early angioplasty after fibrinolysis for acute myocardial infarction". N. Engl. J. Med. 360 (26): 2705–18. doi:10.1056/NEJMoa0808276. PMID 19553646. Unknown parameter
|month=ignored (help) - ↑ Sosnowski C (2008). "[Commentary to the article: Di Mario C, Dudek D, Piscione F, et al.; CARESS-in-AMI (Combined Abciximab RE-teplase Stent Study in Acute Myocardial Infarction) Investigators. Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet 2008; 371: 559-68]". Kardiol Pol (in Polish). 66 (4): 461–4, discussion 465–6. PMID 18634182. Unknown parameter
|month=ignored (help) - ↑ Fernandez-Avilés F, Alonso JJ, Castro-Beiras A; et al. (2004). "Routine invasive strategy within 24 hours of thrombolysis versus ischaemia-guided conservative approach for acute myocardial infarction with ST-segment elevation (GRACIA-1): a randomised controlled trial". Lancet. 364 (9439): 1045–53. doi:10.1016/S0140-6736(04)17059-1. PMID 15380963.
- ↑ White HD (2008). "Systems of care: need for hub-and-spoke systems for both primary and systematic percutaneous coronary intervention after fibrinolysis". Circulation. 118 (3): 219–22. doi:10.1161/CIRCULATIONAHA.108.790170. PMID 18625904. Unknown parameter
|month=ignored (help) - ↑ 18.0 18.1 King SB, Smith SC, Hirshfeld JW, Jacobs AK, Morrison DA, Williams DO; et al. (2008). "2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee". Circulation. 117 (2): 261–95. doi:10.1161/CIRCULATIONAHA.107.188208. PMID 18079354.
- ↑ Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK (2004). "ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction)". Circulation. 110 (9): e82–292. PMID 15339869. Unknown parameter
|month=ignored (help) - ↑ Antman EM, Hand M, Armstrong PW; et al. (2008). "2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee". Circulation. 117 (2): 296–329. doi:10.1161/CIRCULATIONAHA.107.188209. PMID 18071078. Unknown parameter
|month=ignored (help)