2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery Hillis, L. David, MD, FACC; Smith, Peter K., MD, FACC; Anderson, Jeffrey L., MD, FACC, FAHA ...
Journal of the American College of Cardiology,
12/2011, Letnik:
58, Številka:
24
Journal Article
Risk of spontaneous, instrumented, and fatal bleeds higher with prasugrel compared with standard dose clopidogrel Risk of non-CABG bleeds higher with ticagrelor compared with standard dose ...clopidogrel Transition to surgery Wait 5 d after last dose Wait 7 d after last dose Wait 5 d after last dose Appendix 4 Comparisons Among Orally Effective P2Y12 Inhibitors ASA indicates aspirin; BMS, bare-metal stent; DES, drug-eluting stent; CABG, coronary artery bypass graft; PCI, percutaneous coronary intervention; PPI, proton pump inhibitor; TIA, transient ischemic attack; and UA/NSTEMI, unstable angina/non-ST-elevation myocardial infarction. Appendix 5 Flowchart for Class I and Class IIa Recommendations for Initial Management of UA/NSTEMI ASA indicates aspirin; CABG, coronary artery bypass graft; D/C, discontinue; GI, gastrointestinal; GP, glycoprotein; IV, intravenous; LOE, level of evidence; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction; UA/NSTEMI, unstable angina/non-ST-elevation myocardial infarction; and UFH, unfractionated heparin.*A loading dose followed by a daily maintenance dose of either clopidogrel (LOE: Generally Preferred Strategy Patient Characteristics Invasive Recurrent angina or ischemia at rest or with low-level activities despite intensive medical therapy Elevated cardiac biomarkers (TnT or TnI) New or presumably new ST-segment depression Signs or symptoms of HF or new or worsening mitral regurgitation High-risk findings from noninvasive testing Hemodynamic instability Sustained ventricular tachycardia PCI within 6 mo Prior CABG High-risk score (e.g., TIMI, GRACE) Mild to moderate renal dysfunction Diabetes mellitus Reduced LV function (LVEF <40%) Conservative Low-risk score (e.g., TIMI, GRACE) Patient or physician preference in the absence of high-risk features Appendix 6 Selection of Initial Treatment Strategy: Invasive Versus Conservative Strategy CABG indicates coronary artery bypass graft; GRACE, Global Registry of Acute Coronary Events; HF, heart failure; LV, left ventricular; LVEF, left ventricular ejection fraction; PCI, percutaneous coronary intervention; TIMI, Thrombolysis In Myocardial Infarction; TnI, troponin I; and TnT, troponin T.