Tag Archives: NSTEMI

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

8 Oct

2014 AHA:ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes were published on September 23.

The new terminology, from Non STE Miocardial Infarction to Non STE Acute coronary Syndromes, establishes a  pathophysiological continuum between unstable angina and Non STE Acute coronary Syndromes, and make those two identities indistinguishable and considered together in this 2014 Guideline.

The need of High Sensitive Troponin and the importance of risk stratification are just few of the many changes made in this 2014 update

You con find this and all the newst guidelines on MEDEST Guidelines section

Sono state pubblicate il 23 di Settembre le 2014 AHA:ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

Trovate queste e tutte le nuove linee guida su MEDEST nella sezione dedicata

Linee Guida

References:

2014 AHA:ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

New Non-ST-Elevation ACS Guidelines: New Title, New Approach

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Pretreatment with clopidogrel shows no benefit in patients undergoing PCI

20 Dec

Pretreatment with Clopidogrel is a common practice in all  patients (STEMI UA/NSTEMI) undergoing PCI. A freshly pressed systematic review and meta-analysis shows no benefit on pretreatment with Clopidogrel on all mortality causes. The authors concluded that especially low risk patients undergoing elective PCI must be no overtreated questioning the need for pretreatment. A favorable trend is shown only in high-risk STEMI patients undergoing PCI.

Two major RCT trials, examining different antiplatelets agents, ticagrelor ang prasugrel, has been expected to be concluded in 2013, and will shed further light on this issue.

Will be not easy to change practice about a molecule that was been around for so long time, but if also those two new trials will fail the primary end points, pretreatment with antiplatelets agents will be in trouble.

Source:

Bellemain-Appaix A, O’Connor SA, Silvain J, et al. Association of Clopidogrel Pretreatment With Mortality, Cardiovascular Events, and Major Bleeding Among Patients Undergoing Percutaneous Coronary Intervention. A systematic review and meta-analysis.

JAMA 2012; 308:2507-2517.

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