2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Abstract

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Impact of Obstructive Sleep Apnea on Platelet Function Profiles in Patients With Acute Coronary Syndrome Taking Dual Antiplatelet Therapy

“…The new P2Y 12 inhibitors (prasugrel and ticagrelor) have a more predictable response, greater potency and faster onset of characteristics, thus making them the treatment of choice in patients receiving clopidogrel therapy with HRPR. Nowadays, new oral P2Y 12 inhibitors have evidentially been recommended for the treatment of ACS, as they show a reduction in cardiovascular events compared with clopidogrel 11, 12. However, it may be argued that high‐platelet reactivity alone cannot be used as a good indicator for using more potent platelet inhibition, because if OSA also exists, then reducing the potential benefits of ischemic events may be offset by the bleeding rate.…”

“…In this study, we evaluated patients consecutively admitted to Beijing Anzhen Hospital (Beijing, China) with a diagnosis of ACS from June 2015 to May 2017. ACS was defined according to ACS related guidelines 11, 12. Patients were eligible for platelet function analyses if they were in their maintenance steady‐state phase (at least 7 days) of DAPT with aspirin (100 mg/day) and clopidogrel (75 mg/day).…”

Association Between Mineralocorticoid Receptor Antagonist Use and Outcome in Myocardial Infarction Patients With Heart Failure

“…The present study confirms these findings in a nonselected population by demonstrating a 19% lower (hazard ratio [95% CI] 0.81 [0.75–0.88]) mortality in MRA‐treated patients with LVEF <40% and a trend towards lower mortality in those with LVEF 40% to 49% (0.88 [0.75–1.03]), all together strongly supporting the recent ST‐segment–elevation MI guidelines with MRA in patients with LVEF ≤40% as a class I recommendation 15. The low use of MRA in patients with acute MI and LVEF <40% (19.6%) is similar to findings in the United States (14.5%) and should call for actions 16…”

Implementation of a Regional Network for ST‐Segment–Elevation Myocardial Infarction (STEMI) Care and 30‐Day Mortality in a Low‐ to Middle‐Income City in Brazil: Findings From Salvador's STEMI Registry (RESISST)

“…In addition, the populations of low‐ and middle‐income countries such as Brazil are more exposed to cardiovascular risk factors and have less access to health care, including emergency medical services. Globally, several factors contribute to the lack of optimization in the management of STEMI relative to the recommendations of the main national and international guidelines 6, 7, 8. In fact, approximately one third of the patients eligible for reperfusion therapy in the United States do not achieve recommended door‐to‐device time of <120 minutes 9…”