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
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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]
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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]
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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]
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M. Kruk, J. Kadziela, H. R. Reynolds, S. A. Forman, Z. Sadowski, B. A. Barton, D. B. Mark, A. P. Maggioni, J. Leor, J. G. Webb, et al. Predictors of Outcome and the Lack of Effect of Percutaneous Coronary Intervention Across the Risk Strata in Patients With Persistent Total Occlusion After Myocardial Infarction. Results From the Occluded Artery Trial (OAT). J. Am. Coll. Cardiol. Intv., January 1, 2008; 1: 511 - 520. [Abstract] [Full Text] [PDF]
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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]
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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]
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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]
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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]
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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]
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K. M. Goode, A. L. Clark, J. A. Bristow, K. B. Sykes, and J. G.F. Cleland Screening for left ventricular systolic dysfunction in high-risk patients in primary-care: A cost-benefit analysis Eur J Heart Fail, December 1, 2007; 9(12): 1186 - 1195. [Abstract] [Full Text] [PDF]
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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]
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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]
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