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athero.ru
23.11.2011
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Thygesen K, Alpert JS, White H.D.
on behalf of the Joint ESC / ACCF / AHA / WHF Task Force
for the Redefinition of Myocardial Infarction.
Universal definition of myocardial infarction
Eur Heart J
2007;
28: 2525
Circulation 2007;
116: 2634
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Class I
1. Primary PCI should be performed in patients within 12 hours of onset of STEMI.175178 (LOE: A)
2. Primary PCI should be performed in patients with STEMI presenting to a hospital with PCI capability within 90 minutes of first medical
contact as a systems goal.188,189 (LOE: B)
3. Primary PCI should be performed in patients with STEMI presenting to a hospital without PCI capability within 120 minutes of first medical
contact as a systems goal.190192 (Level of Evidence: B)
4. Primary PCI should be performed in patients with STEMI who develop severe heart failure or cardiogenic shock and are suitable candidates
for revascularization as soon as possible, irrespective of time delay.179,180 (LOE: B)
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2. A strategy of coronary angiography (or transfer for coronary angiography) 3 to 24 hours after initiating fibrinolytic therapy with intent to
perform PCI is reasonable for hemodynamically stable patients with STEMI and evidence for successful fibrinolysis when angiography and
revascularization can be performed as soon as logistically feasible in this time frame. (Level of Evidence: A)
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ESC Guidelines for the management of acute coronary syndromes in patients presenting
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ELEVATE
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Mega J et al. Increasing Clopidogrel Based on CYP2C19 Genotype in Patients with Cardiovascular Disease.
AHA Sci sessions. Nov 16, 2011. http://my.americanheart.org/
ELEVATE:
CYP2C19*2
CYP2C19*2
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Mega J et al. Increasing Clopidogrel Based on CYP2C19 Genotype in Patients with Cardiovascular Disease.
AHA Sci sessions. Nov 16, 2011. http://my.americanheart.org/
PLATO
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Gibson , Mega J, Braunwald E. on behalf of the ATLAS ACS 2 TIMI 51 Investigators
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23 FDA
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FDA
,
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At its May 23 meeting, the panel voted six to four (with one abstention) against recommending that the FDA
approve rivaroxaban for reducing the risk of thrombotic cardiovascular events in patients with acute coronary
syndrome or unstable angina in combination with aspirin, aspirin plus clopidogrel, or ticlopidine.
www.theheart.org/
11.06.2012
ATLAS
(good follow-up)
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85%
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5
84%
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0.3%
4%
11%
12%
13%
, ATLAS
() .
The missing data and quality problems preclude ATLAS from providing substantial evidence of effectiveness.
11.06.2012
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ST
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