1 / 29

PCI for STEMI

PCI for STEMI. Ari de la Hera, M.D. N Engl J Med 2006;355:2308-2320. ED physician activates the Cath Lab Single call to activate the Cath Lab Cath Lab operational within 20 minutes of activation Real time data feedback for case review

bary
Download Presentation

PCI for STEMI

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. PCI for STEMI Ari de la Hera, M.D.

  2. N Engl J Med 2006;355:2308-2320 • ED physician activates the Cath Lab • Single call to activate the Cath Lab • Cath Lab operational within 20 minutes of activation • Real time data feedback for case review • Having attending cardiologist always on site • Prehospital ECG to activate Cath Lab while patient is en route

  3. Meta-analysis: Facilitated PCI vs Primary PCI Mortality Reinfarction Major Bleeding 1.81 (1.19-2.77) 1.43 (1.01-2.02) 1.03 (0.49-2.17) 1.40 (0.49-3.98) 3.07 (0.18-52.0) 1.03 (0.15-7.13) 1.38 (1.01-1.87) 1.71 (1.16 - 2.51) 1.51 (1.10 - 2.08 ) 0.1 1 10 0.1 1 10 0.1 1 10 Fac. PCIBetter PPCIBetter Fac. PCIBetter PPCIBetter Fac. PCIBetter PPCIBetter Keeley E, et al. Lancet 2006;367:579.

  4. Stepped Care Approach To Pharmacologic Therapy for Musculoskeletal Symptoms with Known Cardiovascular Disease or Risk Factors for Ischemic Heart Disease • Acetaminophen, ASA, tramadol, narcotic analgesics (short term) • Nonacetylated salicylates • Non COX-2 selective NSAIDs Select patients at low riskof thrombotic events • NSAIDs with some COX-2 activity • Regular monitoring for sustained hypertension or worsening of prior blood pressure control), edema, worsening renal function, or gastrointestinal bleeding. • If these events occur, consider reduction of the dose or discontinuation of the offending drug, a different drug, or alternative therapeutic modalities, as dictated by clinical circumstances. Prescribe lowest doserequired to control symptoms • COX-2 Selective NSAIDs Add ASA 81 mg and PPI to patients at increased risk of thrombotic events * * Addition of ASA may not be sufficient protection against thrombotic events Antman EM, et al. J Am Coll Cardiol 2008. Published ahead of print on December 10, 2007. Available athttp://content.onlinejacc.org/cgi/content/full/j.jacc.2007.10.001.

More Related