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comparison of guidlines ESC 2012 and ACCF/AHA terms of class of recommendation

Management of ST-elevation myocardial infarction according to European and American guidelines. comparison of guidlines ESC 2012 and ACCF/AHA terms of class of recommendation level of evidence. main common recommendations. PCI- capable centre with symptom duration <12 h => <90 min

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comparison of guidlines ESC 2012 and ACCF/AHA terms of class of recommendation

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  1. Management of ST-elevation myocardialinfarctionaccordingto European and American guidelines

  2. comparisonofguidlines ESC 2012 and ACCF/AHA • termsofclassofrecommendation • levelofevidence

  3. maincommonrecommendations • PCI-capablecentre • withsymptomduration <12 h => <90 min • non-PCI centre • <120 min

  4. culpritlesion (exceptcardiogenicshock) • radial approach; thrombusaspiration; DES implantation

  5. prasugrelorticagrelorpreferredoverclopidogrel

  6. During PCI bivalirudinandunfractionedheparinindicated<-> fondaparinuxcontraindicated

  7. dual antiplatelettherapy12 months • BMS 1 month • DES 6 months

  8. fibrinolysis • PCI not possible • large infarct • PCI in >90 • coronaryangiographywithin 3-24 h

  9. post-discharge • optimisingcoronaryriskfactorcontrol • smoke cessation • rehabilitationprogrammes • medication • DAPT 12 month • beta-blockers • ACE /ARB inhibitors • statins: LDL < 70 mg/dl • aldosteroneinhibitors : leftventriculardysfunction • Anticoagulation: leftventriculardisfunction, atrialfibrillation

  10. Differences

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