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  • 2012 ACCF/AHA Focused Updat...
    Jneid, Hani, MD, FACC, FAHA; Anderson, Jeffrey L., MD, FACC, FAHA; Wright, R. Scott, MD, FACC, FAHA; Adams, Cynthia D., RN, PhD, FAHA; Bridges, Charles R., MD, ScD, FACC, FAHA; Casey, Donald E., MD, MPH, MBA, FACP, FAHA; Ettinger, Steven M., MD, FACC; Fesmire, Francis M., MD, FACEP; Ganiats, Theodore G., MD; Lincoff, A. Michael, MD, FACC; Peterson, Eric D., MD, MPH, FACC, FAHA; Philippides, George J., MD, FACC, FAHA; Theroux, Pierre, MD, FACC, FAHA; Wenger, Nanette K., MD, MACC, FAHA; Zidar, James Patrick, MD, FACC, FSCAI

    Journal of the American College of Cardiology, 08/2012, Letnik: 60, Številka: 7
    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.