Copyright © 2003 by the European Society of Cardiology.
Task Force Report
Management of acute myocardial infarction in patients presenting with ST-segment elevation
The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology,Received August 6, 2002; accepted August 7, 2002 * Correspondence: Prof. dr. F. Van de Werf, Cardiology, Gasthuisberg University Hospital, Herestraat 49, B-3000 Leuven, Belgium.
Key Words: Acute myocardial infarction • drug therapy • ischaemic heart disease
| The first 150 words of the full text of this article appear below. |
- Introduction
- The definition of acute myocardial infarction
- The pathogenesis of acute myocardialinfarction
- The natural history of acute myocardial infarction
- Aims of management
- Emergency care
- Initial diagnosis and early risk stratification
- Relief of pain, breathlessness and anxiety
- Cardiac arrest
- Basic life support
- Advanced life support
- Pre-hospital or early in-hospital care
- Restoring coronary flow and myocardial tissue reperfusion
- Fibrinolytic treatment
- Fibrinolytic regimens
- Percutaneous coronary interventions (PCI)
- Primary PCI
- PCI combined with fibrinolysis
- ‘Rescue’ PCI
- Assessing myocardial salvage by fibrinolysis or PCI
- GP IIb/IIIa antagonists and early PCI
- Coronary artery bypass surgery
- Pump failure and shock
- Heart failure
- Mild and moderately severe heart failure
- Severe heart failure and shock
- Mechanical complications: cardiac rupture and mitral regurgitation
- Free wall rupture
- Ventricular septal rupture
- Mitral regurgitation
- Arrhythmias and conduction disturbances
- Ventricular arrhythmias
- Supraventricular arrhythmias
- Sinus bradycardia and heart block
- Routine prophylactic therapies in the acute phase
- Management of specific types of infarction
- Right ventricular infarction
. . . [Full Text of this Article] - The definition of acute myocardial infarction
The definition of acute myocardial infarction
The pathogenesis of acute myocardial infarction
The natural history of acute myocardial infarction
Aims of management
Emergency care
Initial diagnosis and early risk stratification
Relief of pain, breathlessness and anxiety
Cardiac arrest
Basic life support
Advanced life support
Pre-hospital or early in-hospital care
Restoring coronary flow and myocardial tissue reperfusion
Fibrinolytic treatment
The evidence for benefit
Time to treatment
Hazards of fibrinolysis
Comparison of fibrinolytic agents
Clinical implications
Contra-indications to fibrinolytic therapy
Fibrinolytic regimens
Re-administration of a fibrinolytic agent
Adjunctive anticoagulant and antiplatelet therapy
Percutaneous coronary interventions (PCI)
Primary PCI
PCI combined with fibrinolysis
‘Rescue PCI’
Assessing myocardial salvage by fibrinolysis or PCI
GP IIb/IIIa antagonists and early PCI
Coronary artery bypass surgery
Pump failure and shock
Heart failure
Mild and moderately severe heart failure
Severe heart failure and shock
Cardiogenic shock
Mechanical complications: cardiac rupture and mitral regurgitation
Free wall rupture
Acute free wall rupture
Subacute free wall rupture
Ventricular septal rupture
Mitral regurgitation
Arrhythmias and conduction disturbances
Ventricular arrhythmias
Ventricular ectopic rhythms
Ventricular tachycardia
Ventricular fibrillation
Supraventricular arrhythmias
Sinus bradycardia and heart block
First-degree heart block needs no treatment
Routine prophylactic therapies in the acute phase
Aspirin
Anti-arrhythmic drugs
Beta-blockers
Nitrates
Calcium antagonists
Angiotensin-converting enzyme (ACE) inhibitors
Magnesium
Glucose-insulin-potassium
Management of specific types of infarction
Right ventricular infarction
Myocardial infarction in diabetic patients
Management of the later in-hospital course
Ambulation
Management of specific in-hospital complications
Deep vein thrombosis and pulmonary embolism
Intraventricular thrombus and systemic emboli
Pericarditis
Late ventricular arrhythmias
Post-infarction angina and ischaemia
Risk assessment, rehabilitation and secondary prevention
Risk assessment
Timing
Clinical assessment and further investigations
Assessment of myocardial viability, stunning and hibernation
Evaluation of risk of arrhythmia
Rehabilitation
Psychological and socio-economic aspects
Lifestyle advice
Physical activity
Secondary prevention
Smoking
Diet and dietary supplements
Antiplatelet and anticoagulant treatment
Beta-blockers
Calcium antagonists
Nitrates
Angiotensin-converting enzyme (ACE) inhibitors
Lipid-lowering agents
Logistics of care
Pre-hospital care
Patient delay
Public education in cardiopulmonary resuscitation
The ambulance service
General practitioners
Admission procedures
The coronary (cardiac) care unit (CCU)
Non-invasive monitoring
Invasive monitoring
The current use of therapies tested by clinical trials
Recommendations
Patients
Cardiologists
General practitioners
Health authorities
Procedure of the Task Force
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. N. Tziakas, G. K. Chalikias, I. K. Tentes, D. Stakos, S. V. Chatzikyriakou, K. Mitrousi, A. X. Kortsaris, J. C. Kaski, and H. Boudoulas Interleukin-8 is increased in the membrane of circulating erythrocytes in patients with acute coronary syndrome Eur. Heart J., September 2, 2008; (2008) ehn382v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fox Benefits of perindopril all along the cardiovascular continuum: the level of evidence Eur. Heart J. Suppl., September 1, 2008; 10(suppl_G): G4 - G12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Manari, P. Ortolani, P. Guastaroba, G. Casella, L. Vignali, E. Varani, G. Piovaccari, V. Guiducci, G. Percoco, S. Tondi, et al. Clinical impact of an inter-hospital transfer strategy in patients with ST-elevation myocardial infarction undergoing primary angioplasty: the Emilia-Romagna ST-segment elevation acute myocardial infarction network Eur. Heart J., August 1, 2008; 29(15): 1834 - 1842. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Bates and B. K. Nallamothu Commentary: The Role of Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction Circulation, July 29, 2008; 118(5): 567 - 573. [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Tejada, F. Hernandez, J. Chimeno, M. A. Alonso, R. Martin, and T. Bastante Acute Pancreatitis Mimicking Acute Inferior Myocardial Infarction Angiology, July 1, 2008; 59(3): 365 - 367. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Hirsch, R. Nijveldt, J. D.E. Haeck, A. M. Beek, K. T. Koch, J. P.S. Henriques, R. J. van der Schaaf, M. M. Vis, J. Baan Jr, R. J. de Winter, et al. Relation between the assessment of microvascular injury by cardiovascular magnetic resonance and coronary Doppler flow velocity measurements in patients with acute anterior wall myocardial infarction. J. Am. Coll. Cardiol., June 10, 2008; 51(23): 2230 - 2238. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mozaffarian Fish and n-3 fatty acids for the prevention of fatal coronary heart disease and sudden cardiac death Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1991S - 1996S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Zoeller Jr Lifestyle and the Risk of Cardiovascular Disease in Women: Is Physical Activity an Equal Opportunity Benefactor? American Journal of Lifestyle Medicine, June 1, 2008; 2(3): 219 - 226. [Abstract] [PDF]
|
|
|
|
|
|
P. Ortolani, A. Marzocchi, C. Marrozzini, T. Palmerini, F. Saia, N. Taglieri, F. Baldazzi, S. Silenzi, M. L. Bacchi-Reggiani, P. Guastaroba, et al. Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention Eur. Heart J., May 2, 2008; 29(10): 1241 - 1249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Brener, D. J. Moliterno, P. E. Aylward, A. W.J. van't Hof, W. Ruzyllo, W. W. O'Neill, C. W. Hamm, C. M. Westerhout, C. B. Granger, P. W. Armstrong, et al. Reperfusion after primary angioplasty for ST-elevation myocardial infarction: predictors of success and relationship to clinical outcomes in the APEX-AMI Angiographic Study Eur. Heart J., May 1, 2008; 29(9): 1127 - 1135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. McDonald, Y. Fu, U. Zeymer, G. Wagner, S. G. Goodman, A. Ross, C. B. Granger, F. Van de Werf, P. W. Armstrong, and for the ASSENT-4 PCI Investigators Adverse outcomes in fibrinolytic-based facilitated percutaneous coronary intervention: insights from the ASSENT-4 PCI electrocardiographic substudy Eur. Heart J., April 1, 2008; 29(7): 871 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Eagle, B. K. Nallamothu, R. H. Mehta, C. B. Granger, P. G. Steg, F. Van de Werf, J. Lopez-Sendon, S. G. Goodman, A. Quill, K. A.A. Fox, et al. Trends in acute reperfusion therapy for ST-segment elevation myocardial infarction from 1999 to 2006: we are getting better but we have got a long way to go Eur. Heart J., March 1, 2008; 29(5): 609 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Marcassa, J. J. Bax, F. Bengel, B. Hesse, C. L. Petersen, E. Reyes, R. Underwood, and on behalf of the European Council of Nuclear Cardi Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement Eur. Heart J., February 2, 2008; 29(4): 557 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J.G. Peters, C. Joyner, J.-P. Bassand, R. Afzal, S. Chrolavicius, S. R. Mehta, J. Oldgren, L. Wallentin, A. Budaj, K. A. Fox, et al. The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction: a subgroup analysis of the OASIS-6 trial Eur. Heart J., February 1, 2008; 29(3): 324 - 331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Holmes Jr, M. R. Bell, B. J. Gersh, C. S. Rihal, L. H. Haro, C. M. Bjerke, R. J. Lennon, C.-C. Lim, and H. H. Ting Systems of Care to Improve Timeliness of Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction During Off Hours: The Mayo Clinic STEMI Protocol J. Am. Coll. Cardiol. Intv., February 1, 2008; 1(1): 88 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Le May, D. Y. So, R. Dionne, C. A. Glover, M. P.V. Froeschl, G. A. Wells, R. F. Davies, H. L. Sherrard, J. Maloney, J.-F. Marquis, et al. A Citywide Protocol for Primary PCI in ST-Segment Elevation Myocardial Infarction N. Engl. J. Med., January 17, 2008; 358(3): 231 - 240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Berger, A. Stebbins, C. B. Granger, E. M. Ohman, P. W. Armstrong, F. Van de Werf, H. D. White, R. J. Simes, R. A. Harrington, R. M. Califf, et al. Initial Aspirin Dose and Outcome Among ST-Elevation Myocardial Infarction Patients Treated With Fibrinolytic Therapy Circulation, January 15, 2008; 117(2): 192 - 199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Voo, J. Eggermann, M. Dunaeva, C. Ramakers-van Oosterhoud, and J. Waltenberger Enhanced functional response of CD133+ circulating progenitor cells in patients early after acute myocardial infarction Eur. Heart J., January 2, 2008; 29(2): 241 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Mellbin, K. Malmberg, A. Norhammar, H. Wedel, L. Ryden, and for the DIGAMI 2 Investigators The impact of glucose lowering treatment on long-term prognosis in patients with type 2 diabetes and myocardial infarction: a report from the DIGAMI 2 trial Eur. Heart J., January 2, 2008; 29(2): 166 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Wallentin, C. Varenhorst, S. James, D. Erlinge, O. O Braun, J. A. Jakubowski, A. Sugidachi, K. J. Winters, and A. Siegbahn Prasugrel achieves greater and faster P2Y12receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease Eur. Heart J., January 1, 2008; 29(1): 21 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Gitt and A. Betriu Antiplatelet therapy in acute coronary syndromes Eur. Heart J. Suppl., January 1, 2008; 10(suppl_A): A4 - A12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bode and K. Huber Antiplatelet therapy in percutaneous coronary intervention Eur. Heart J. Suppl., January 1, 2008; 10(suppl_A): A13 - A20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Bertrand When and how to discontinue antiplatelet therapy Eur. Heart J. Suppl., January 1, 2008; 10(suppl_A): A35 - A41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Eskola, L. Holmvang, K. C. Nikus, S. Sclarovsky, H.-H. Tilsted, H. Huhtala, K. O. Niemela, and P. Clemmensen The electrocardiographic window of opportunity to treat vs. the different evolving stages of ST-elevation myocardial infarction: correlation with therapeutic approach, coronary anatomy, and outcome in the DANAMI-2 trial Eur. Heart J., December 2, 2007; 28(24): 2985 - 2991. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Giraldez and E. M. Antman Enoxaparin and ST-elevation myocardial infarction: reply Eur. Heart J., December 1, 2007; 28(23): 2952 - 2953. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Otter, M. Winter, W. Doering, E. Standl, and O. Schnell C-Reactive Protein in Diabetic and Nondiabetic Patients With Acute Myocardial Infarction Diabetes Care, December 1, 2007; 30(12): 3080 - 3082. [Full Text] [PDF]
|
|
|
|
|
|
B. K. Nallamothu, E. H. Bradley, and H. M. Krumholz Time to Treatment in Primary Percutaneous Coronary Intervention N. Engl. J. Med., October 18, 2007; 357(16): 1631 - 1638. [Full Text] [PDF]
|
|
|
|
|
|
R. F. Zoeller JR Physical Activity: The Role of Physical Activity and Fitness in the Prevention and Management of Type 2 Diabetes Mellitus American Journal of Lifestyle Medicine, October 1, 2007; 1(5): 344 - 350. [Abstract] [PDF]
|
|
|
|
 |
|
 I. Travale Review: short duration of bed rest was as safe as long duration after acute uncomplicated myocardial infarction Evid. Based Nurs., October 1, 2007; 10(4): 116 - 116. [Full Text] [PDF]
|
|
|
|
|
|
S. Carstensen, G. C.I. Nelson, P. S. Hansen, L. Macken, S. Irons, M. Flynn, P. Kovoor, S. Y. Soo Hoo, M. R. Ward, and H. H. Rasmussen Field triage to primary angioplasty combined with emergency department bypass reduces treatment delays and is associated with improved outcome Eur. Heart J., October 1, 2007; 28(19): 2313 - 2319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Murphy, C. M. Gibson, D. A. Morrow, F. Van de Werf, I. B. Menown, S. G. Goodman, K. W. Mahaffey, M. Cohen, C. H. McCabe, E. M. Antman, et al. Efficacy and safety of the low-molecular weight heparin enoxaparin compared with unfractionated heparin across the acute coronary syndrome spectrum: a meta-analysis Eur. Heart J., September 1, 2007; 28(17): 2077 - 2086. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Henry, S. W. Sharkey, M. N. Burke, I. J. Chavez, K. J. Graham, C. R. Henry, D. L. Lips, J. D. Madison, K. M. Menssen, M. R. Mooney, et al. A Regional System to Provide Timely Access to Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction Circulation, August 14, 2007; 116(7): 721 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Faxon Development of Systems of Care for ST-Elevation Myocardial Infarction Patients: Current State of ST-Elevation Myocardial Infarction Care Circulation, July 10, 2007; 116(2): e29 - e32. [Full Text] [PDF]
|
|
|
|
 |
|
 F.-X. Duchateau, M L Devaud, A Burnod, J Mantz, and A Ricard-Hibon A quality control programme for acute myocardial infarction management in out-of-hospital critical care medicine Emerg. Med. J., July 1, 2007; 24(7): 487 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-W. Siu, M.-H. Jim, H.-H. Ho, R. Miu, S. W.L. Lee, C.-P. Lau, and H.-F. Tse Transient Atrial Fibrillation Complicating Acute Inferior Myocardial Infarction: Implications for Future Risk of Ischemic Stroke Chest, July 1, 2007; 132(1): 44 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology Eur. Heart J., July 1, 2007; 28(13): 1598 - 1660. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Travers Achieving optimal care for ST-segment elevation myocardial infarction in Canada Can. Med. Assoc. J., June 19, 2007; 176(13): 1843 - 1844. [Full Text] [PDF]
|
|
|
|
|
|
K. A.A. Fox, E. M. Antman, G. Montalescot, S. Agewall, B. SomaRaju, F. W.A. Verheugt, J. Lopez-Sendon, H. Hod, S. A. Murphy, and E. Braunwald The Impact of Renal Dysfunction on Outcomes in the ExTRACT-TIMI 25 Trial J. Am. Coll. Cardiol., June 12, 2007; 49(23): 2249 - 2255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Montalescot, J. Dallongeville, E. Van Belle, S. Rouanet, C. Baulac, A. Degrandsart, E. Vicaut, and for the OPERA Investigators STEMI and NSTEMI: are they so different? 1 year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the OPERA registry) Eur. Heart J., June 2, 2007; 28(12): 1409 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Birnbaum, Y. Lin, Y. Ye, J. D. Martinez, M.-H. Huang, C. Y. Lui, J. R Perez-Polo, and B. F. Uretsky Aspirin before reperfusion blunts the infarct size limiting effect of atorvastatin Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2891 - H2897. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. Dirksen, G. J. Laarman, M. L. Simoons, and D. J.G.M. Duncker Reperfusion injury in humans: A review of clinical trials on reperfusion injury inhibitory strategies Cardiovasc Res, June 1, 2007; 74(3): 343 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Sohail, D. Z. Uslan, A. H. Khan, P. A. Friedman, D. L. Hayes, W. R. Wilson, J. M. Steckelberg, S. Stoner, and L. M. Baddour Management and Outcome of Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infections J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1851 - 1859. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. A. Fox, P. G. Steg, K. A. Eagle, S. G. Goodman, F. A. Anderson Jr, C. B. Granger, M. D. Flather, A. Budaj, A. Quill, J. M. Gore, et al. Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006 JAMA, May 2, 2007; 297(17): 1892 - 1900. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Boos, S. K. Soor, D. Kang, and G. Y.H. Lip Relationship between circulating endothelial cells and the predicted risk of cardiovascular events in acute coronary syndromes Eur. Heart J., May 1, 2007; 28(9): 1092 - 1101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The TRIUMPH Investigators Effect of Tilarginine Acetate in Patients With Acute Myocardial Infarction and Cardiogenic Shock: The TRIUMPH Randomized Controlled Trial JAMA, April 18, 2007; 297(15): 1657 - 1666. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Dalby, M. Roughton, C. Ilsley, J. E. de LaCoussaye, P. A. Carli, V. A. Umans, H. O. Peels, T. Wharton, J. Hall, T. Roberts, et al. Door-to-Balloon Time in Acute Myocardial Infarction N. Engl. J. Med., April 5, 2007; 356(14): 1475 - 1479. [Full Text] [PDF]
|
|
|
|
|
|
F. Fernandez-Aviles, J. J. Alonso, G. Pena, J. Blanco, J. Alonso-Briales, J. Lopez-Mesa, F. Fernandez-Vazquez, J. Moreu, R. A. Hernandez, A. Castro-Beiras, et al. Primary angioplasty vs. early routine post-fibrinolysis angioplasty for acute myocardial infarction with ST-segment elevation: the GRACIA-2 non-inferiority, randomized, controlled trial Eur. Heart J., April 2, 2007; 28(8): 949 - 960. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W. Armstrong Ruminating on OAT: is the case closed? Eur. Heart J., March 1, 2007; 28(5): 531 - 532. [Full Text] [PDF]
|
|