Antman
et al., Management of Patients With STEMI: Executive Summary
J Am Coll Cardiol 2004;44:671-719
ACC/AHA
Guidelines for the Management of Patients With ST-Elevation Myocardial
Infarction—Executive Summary
A
Report of the American College of Cardiology/American Heart Association
Task Force on Practice Guidelines (Writing Committee to Revise the
1999 Guidelines for the Management of Patients With Acute Myocardial
Infarction)
Developed
in Collaboration With the Canadian Cardiovascular Society
Figures and Tables
Appendix
1. ACC/AHA Committee to Revise the 1999 Guidelines
for Management of Acute Myocardial Infarction—Relationships
With Industry
Appendix 1, continued
Appendix 2. External
Peer Reviewers for the ACC/AHA Guidelines for the Management of
Patients With ST-Elevation Myocardial Infarction
Appendix 2a
Appendix 2b
Appendix
2c
Appendix 2d
Appendix 2e
Appendix 3. Abbreviations
Appendix 3a
Figure
1. Evolution
of ACC/AHA guidelines for management of patients with acute MI.
Figure
2. Acute coronary syndromes.
Figure 3. Relative
treatment effect associated with several acute reperfusion modalities
in patients presenting with STEMI.
Figure 4. Patient
(advance) instructions for nitroglycerin use and EMS contact in
the setting of non–trauma-related chest discomfort/pain.
Figure 5. Use
the T.I.M.E. method to help your patients make a heart attack survival
plan.
Figure 6. Options
for transportation of patients with STEMI and initial reperfusion
treatment.
Figure 7. Major
components of time delay between onset of symptoms from ST-elevation
MI and restoration of flow in the infarct artery.
Figure 8. Cumulative
distribution of call-to-needle time.
Figure 9. Algorithm
for evaluation and management of patients suspected of having acute
coronary syndrome.
Figure 10. Risk
stratification: electrocardiogram (ECG).
Figure 11. Cardiac
biomarkers in ST-elevation myocardial infarction (STEMI).
Figure 12. Algorithm
for diagnosing recurrent MI after the index STEMI event.
Figure 13. Mortality
differences during days 0 through 35 subdivided by presentation
features in a collaborative overview of results from nine trials
of fibrinolytic therapy.
Figure 14. Percutaneous
coronary intervention (PCI) versus fibrinolysis for ST-elevation
myocardial infarction (STEMI).
Figure 15. PCI
versus lysis with fibrin-specific agents:is timing (almost) everything?
Figure 16. Effect
of fibrinolytic therapy on mortality according to admission electrocardiogram.
Figure 17. Estimation
of risk of ICH with fibrinolysis.
Figure 18. Adjusted
probability of death or cerebral bleeding in relation to fibrinolytic
therapy
Figure 19. Algorithm
for evaluation of intracranial hemorrhage complicating fibrinolytic
therapy for ST-elevation myocardial infarction.
Figure 20. Nomogram
for prediction of 30-day mortality following intracranial hemorrhage
in patients receiving fibrinolysis.
Figure 21. Symptom
onset-balloon time and mortality in primary PCI for ST-elevation
myocardial infarction.
Figure 22. Relationship
between 30-day mortality and time from study enrollment to first
balloon inflation.
Figure 23. Comparison
of elapsed time to fibrinolysis versus primary PCI.
Figure 24. Door-to-balloon
times: patients transferred in NRMI 4.
Figure 25. Primary
stenting versus primary angioplasty.
Figure 26. Recommendations
for initial reperfusion therapy when cardiogenic shock complicates
STEMI.
Figure 27. Summary
of data from meta-analysis of trials of beta-blocker therapy from
the prefibrinolytic era in patients with myocardial infarction.
Figure 28. Emergency
management of complicated ST-elevation myocardial infarction (STEMI).
Figure 29. Kaplan-Meier
survival of cardiogenic shock after early revascularization curve
1-year postrandomization.
Figure 30. Right
ventricular infarction.
Figure 31. Mechanical
complications of ST-elevation myocardial infarction (STEMI).
Figure 32. An
evidence-based algorithm for primary prevention of sudden death
in post-STEMI patients
Figure 33. Twelve-lead
ECG in a patient with anterior STEMI complicated by right bundle-branch
block (RBBB) and left anterior fascicular block.
Figure 34. Algorithm
for management of recurrent ischemia/infarction after ST-elevation
myocardial infarction (STEMI).
Figure 35. Algorithm
for postreperfusion ischemic stroke treatment.
Figure 36. Evidence-based
approach to need for catheterization (cath) and revascularization
after ST-elevation myocardial infarction (STEMI).
Figure 37. Long-term
antithrombotic therapy at hospital discharge after ST-elevation
myocardial infarction (STEMI).
Tables
Table
1. Applying Classification of Recommendations and Level
of Evidence
Table 2. Reasons
Patients Delay Seeking Medical Attention for Symptoms of ST-Elevation
Myocardial Infarction
Table 3. Reperfusion
checklist for evaluation of the patient with STEMI
Table 4. Prehospital
and Inhospital Fibrinolysis
Table 4 continued
Table 5. Brief
Physical Examination in the Emergency Department
Table 6. Physical
Findings and Possible Implications in Complicated and Uncomplicated
ST-Elevation Myocardial Infarction Patients
Table 7. Percent
Mortality by Killip Class
Table 8. Differential
Diagnosis of ST-Elevation Myocardial Infarction
Table 9. Laboratory
Evaluations for Management of ST-Elevation Myocardial Infarction
Table 10. Molecular
Biomarkers for the Evaluation of Patients With ST-Elevation Myocardial
Infarction
Table 11. Assessment
of Reperfusion Options for Patients with STEMI
Table 12. Contraindications
and Cautions for Fibrinolysis in ST-Elevation Myocardiac Infarction
Table 13. Models
for Estimating Risk of ICH
Table 14. Stroke
Complications in Large Comparative Acute ST-Elevation Myocardial
Infarction Intravenous Fibrinolysis Trials
Table 15. Comparison
of Approved Fibrinolytic Agents
Table 16. Criteria
for Performance of Primary PCI at Hospitals Without Onsite Cardiac
Surgery
Table 17. Patient
Selection for Primary PCI and Emergency Aorto-Coronary Bypass at
Hospitals Without Onsite Cardiac Surgery
Table 18. Transport
of Patients With STEMI for Primary PCI
Table 19. Trials
of Low-Molecular Weight Heparin in Patients With ST-Elevation Myocardial
Infarction
Table 19, continued
Table 20. Trials
of Direct Thrombin Inhibitors Used as Ancillary Therapy in Patients
With ST-Elevation Myocardial Infarction
Table 20, continued
Table 21. Trials
of Glucose-Insulin-Potassium (GIK) for ST-Elevation Myocardial Infarction
Table 22. Randomized
Controlled Trials of Mg2+ in Myocardial Infarction
Table 23. Sample
Admitting Orders for the Patient With STEMI
Table 24. Milestones
and Recommended Information for Educating the Patient With ST-Elevation
Myocardial Infarction
Table 25. Characteristics
of Ventricular Septal Rupture (VSR), Rupture of the Ventricular
Free Wall, and Papillary Muscle Rupture
Table 26. Clinical
Trials of Secondary Prevention of Sudden Death in ICDs: Applicability
to the Post-MI Population
Table 27. Clinical
Trials of Prevention of Sudden Death in ICDs: Applicability to the
Post-MI Population
Table 28. Clinical
Significance of AF During STEMI as Reported in Modern Randomized
Controlled Trials
Table 29. Recommendations
for Treatment of Atrioventricular and Intraventricular Conduction
Disturbances During ST-Elevation Myocardial Infarction
Table 29, continued
Table 30. Features
of AV Conduction Disturbances in Acute Myocardial Infarction
Table 31. Comparison
of Hospital Mortality for CABG With Respect to Time of Operation
Table 32. Secondary
Prevention for Pat
Table 32, continued
Table 33. Aspirin
Versus Warfarin Therapy After ST-Elevation Myocardial Infarction
(STEMI)
Table 34. Energy
Levels Required to Perform Some Common Activities
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