2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update)

Jneid, Hani; Anderson, Jeffrey L.; Wright, R. Scott; Adams, Cynthia D.; Bridges, Charles R.; Casey, Donald E.; Ettinger, Steven M.; Fesmire, Francis M.; Ganiats, Théodore G.; Lincoff, A. Michael; Peterson, Eric D.; Philippides, George J.; Théroux, Pierre; Wenger, Nanette K.; Zidar, James P.

doi:10.1016/j.jacc.2012.06.004

Cited by 502 publications

(302 citation statements)

References 200 publications

(174 reference statements)

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“…These factors included patients’ age, sex, race/ethnicity, mode of transportation, hospital length of stay, history of previously diagnosed comorbidities and cardiac procedures, AMI type (STEMI versus NSTEMI) and order (initial versus previous), clinical signs and symptoms, and laboratory findings on admission 20, 21. Information on the development of important in‐hospital complications, including atrial fibrillation,22 CS,6 heart failure,23 and stroke,24 was collected.…”

Section: Methodsmentioning

confidence: 99%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

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BackgroundCardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population‐based perspective. Our study objectives were to describe decade‐long trends in the incidence, in‐hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) ≥24 hours after hospitalization (late CS).Methods and ResultsThe study population consisted of 5782 patients with an acute myocardial infarction who were admitted to all 11 hospitals in central Massachusetts on a biennial basis between 2001 and 2011. The overall proportion of patients who developed CS was 5.2%. The proportion of patients with prehospital CS (1.6%) and late CS (1.5%) remained stable over time, whereas the proportion of patients with early CS declined from 2.2% in 2001–2003 to 1.2% in 2009–2011. In‐hospital mortality for prehospital CS increased from 38.9% in 2001–2003 to 53.6% in 2009–2011, whereas in‐hospital mortality for early and late CS decreased over time (35.9% and 64.7% in 2001–2003 to 15.8% and 39.1% in 2009–2011, respectively).ConclusionsDevelopment of prehospital and in‐hospital CS was associated with poor short‐term survival and the in‐hospital death rates among those with prehospital CS increased over time. Interventions focused on preventing or treating prehospital and late CS are needed to improve in‐hospital survival after acute myocardial infarction.

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Section: Methodsmentioning

confidence: 99%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

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“…Clopidogrel is established as a beneficial therapy in patients with ACS, 13 and is recommended as part of the treatment of these patients. 7 Clopidogrel is a thienopyridine prodrug, and its conversion to its active metabolite R-130964 requires a two-step process in the liver (Figure 1). 8 Through biotransformation, R-130964 irreversibly inhibits platelet aggregation.…”

Section: Current P2y 12 Inhibitorsmentioning

confidence: 99%

“…8,19 Clinical evidence for DAPT Clopidogrel Several major studies of platelet P2Y 12 -receptor inhibitors involving patients with ACS and those undergoing PCI form the evidence base for the US and European guideline recommendations. [3][4][5][6][7] In the CURE trial, 20 12,562 patients with non-ST-segment elevation ACS were treated with clopidogrel (300 mg loading dose, 75 mg daily maintenance dose) plus aspirin (81-325 mg daily) or aspirin alone. At 12 months, clopidogrel plus aspirin was associated with a 20% relative reduction compared with aspirin alone (9.3% vs 11.4%; P = 0.00009) in the primary composite end point of cardiovascular death, nonfatal myocardial infarction (MI), and nonfatal stroke.…”

Section: Current P2y 12 Inhibitorsmentioning

confidence: 99%

“…In these clinical settings, the use of a P2Y 12 inhibitor combined with aspirin is recommended in the ACC/ AHA and ESC guidelines. [3][4][5][6][7] These recommendations are based primarily on large, phase III, randomized, controlled trials of these agents. In addition, patients who are poor responders or who have a high on-treatment platelet reactivity to ADP during DAPT are at increased risk of ischaemic events after PCI.…”

Section: Introductionmentioning

confidence: 99%

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World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

et al. 2014

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| Guideline recommendations on the use of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes and in those undergoing percutaneous coronary intervention (PCI) have been formulated by both the ACC/AHA and the ESC. These recommendations are based primarily on large, phase III, randomized, controlled trials of the P2Y 12 inhibitors clopidogrel, prasugrel, and ticagrelor. However, few East Asian patients have been included in the trials to assess the use of these agents, particularly the newer agents prasugrel and ticagrelor. Additionally, an increasing body of data suggests that East Asian patients have differing risk profiles for both thrombophilia and bleeding compared with white patients, and that a different 'therapeutic window' of on-treatment platelet reactivity might be appropriate in East Asian patients. Furthermore, a phenomenon referred to as the 'East Asian paradox' has been described, in which East Asian patients have a similar or even a lower rate of ischaemic events after PCI compared with white patients, despite a higher level of platelet reactivity during DAPT. Recognizing these concerns, the World Heart Federation has undertaken this evidence-based review and produced this expert consensus statement to determine the antiplatelet treatment strategies that are most appropriate for East Asian patients.

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“…Yet, the optimal timing of administration of P2Y 12 inhibitors has been a moving target for patients with non‐ST‐elevation myocardial infarction (NSTEMI). Earlier American College of Cardiology/American Heart Association guidelines had provided a class 1 recommendation (level of evidence A) for P2Y 12 inhibitors to be administered as soon as possible in patients presenting with NSTEMI 4. Nevertheless, data from this time period5 showed that only 57% of NSTEMI patients received P2Y 12 inhibitors within the first 24 hours of admission.…”

Section: Introductionmentioning

confidence: 99%

Precatheterization Use of P2Y ₁₂ Inhibitors in Non‐ST‐Elevation Myocardial Infarction Patients Undergoing Early Cardiac Catheterization and In‐Hospital Coronary Artery Bypass Grafting: Insights From the National Cardiovascular Data Registry ^®

Badri

Abdelbaky

et al. 2017

JAHA

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BackgroundCurrent guidelines recommend early P2Y12 inhibitor administration in non‐ST‐elevation myocardial infarction, but it is unclear if precatheterization use is associated with longer delays to coronary artery bypass grafting (CABG) or higher risk of post‐CABG bleeding and transfusion. This study examines the patterns and outcomes of precatheterization P2Y12 inhibitor use in non‐ST‐elevation myocardial infarction patients who undergo CABG.Methods and ResultsRetrospective analysis was done of 20 304 non‐ST‐elevation myocardial infarction patients in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry (2009–2014) who underwent catheterization within 24 hours of admission and CABG during the index hospitalization. Using inverse probability‐weighted propensity adjustment, we compared time from catheterization to CABG, post‐CABG bleeding, and transfusion rates between patients who did and did not receive precatheterization P2Y12 inhibitors. Among study patients, 32.9% received a precatheterization P2Y12 inhibitor (of these, 2.2% were given ticagrelor and 3.7% prasugrel). Time from catheterization to CABG was longer among patients who received precatheterization P2Y12 inhibitor (median 69.9 hours [25th, 75th percentiles 28.2, 115.8] versus 43.5 hours [21.0, 71.8], P<0.0001), longer for patients treated with prasugrel (median 114.4 hours [66.5, 155.5]) or ticagrelor (90.4 hours [48.7, 124.5]) compared with clopidogrel (69.3 [27.5, 114.6], P<0.0001). Precatheterization P2Y12 inhibitor use was associated with a higher risk of post‐CABG major bleeding (75.7% versus 73.4%, adjusted odds ratio 1.33, 95% confidence interval 1.22‐1.45, P<0.0001) and transfusion (47.6% versus 35.7%, adjusted odds ratio 1.51, 95% confidence interval 1.41‐1.62, P<0001); these relationships did not differ among patients treated with clopidogrel, prasugrel, or ticagrelor.ConclusionsPrecatheterization P2Y12 inhibitor use occurs commonly among non‐ST‐elevation myocardial infarction patients who undergo early catheterization and in‐hospital CABG. Despite longer delays to surgery, the majority of pretreated patients proceed to CABG <3 days postcatheterization. Precatheterization P2Y12 inhibitor use is associated with higher risks of postoperative bleeding and transfusion.

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2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update)

Cited by 502 publications

References 200 publications

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

Precatheterization Use of P2Y ₁₂ Inhibitors in Non‐ST‐Elevation Myocardial Infarction Patients Undergoing Early Cardiac Catheterization and In‐Hospital Coronary Artery Bypass Grafting: Insights From the National Cardiovascular Data Registry ^®

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2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update)

Cited by 502 publications

References 200 publications

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

Precatheterization Use of P2Y 12 Inhibitors in Non‐ST‐Elevation Myocardial Infarction Patients Undergoing Early Cardiac Catheterization and In‐Hospital Coronary Artery Bypass Grafting: Insights From the National Cardiovascular Data Registry ®

Contact Info

Product

Resources

About

Precatheterization Use of P2Y ₁₂ Inhibitors in Non‐ST‐Elevation Myocardial Infarction Patients Undergoing Early Cardiac Catheterization and In‐Hospital Coronary Artery Bypass Grafting: Insights From the National Cardiovascular Data Registry ^®