2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion
| Autor: | Christopher B. Fordyce, Derek So, Kevin R. Bainey, John A. Cairns, Paul W. Armstrong, John Ducas, Michel R. Le May, Graham C. Wong, Sohrab Lutchmedial, Sanjit S. Jolly, Shamir R. Mehta, David A. Wood, Michelle Welsford, Michele Perry Arnesen, Erick Schampaert, Colleen M. Norris, Sheldon Cheskes, Ata ur Rehman Quraishi, Madhu K. Natarajan, Sean van Diepen, Jean Francois Tanguay, Akshay Bagai, Mouheiddin Traboulsi, Thao Huynh, Gregory Schnell, Jennifer Greene, Laurie J. Lambert, Jennifer McVey, Christopher B. Overgaard, V. Dzavik, Robert C. Welsh, Craig Ainsworth, Wael Abuzeid, Warren J. Cantor |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Canada
medicine.medical_specialty Cardiology Psychological intervention 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Reperfusion therapy Randomized controlled trial law Humans Medicine cardiovascular diseases 030212 general & internal medicine Myocardial infarction Disease management (health) Intensive care medicine Societies Medical Interventional cardiology business.industry Disease Management Guideline Canadian Cardiovascular Society medicine.disease Practice Guidelines as Topic ST Elevation Myocardial Infarction Cardiology and Cardiovascular Medicine business |
| Zdroj: | Canadian Journal of Cardiology. 35:107-132 |
| ISSN: | 0828-282X |
| Popis: | Rapid reperfusion of the infarct-related artery is the cornerstone of therapy for the management of acute ST-elevation myocardial infarction (STEMI). Canada's geography presents unique challenges for timely delivery of reperfusion therapy for STEMI patients. The Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology STEMI guideline was developed to provide advice regarding the optimal acute management of STEMI patients irrespective of where they are initially identified: in the field, at a non-percutaneous coronary intervention-capable centre or at a percutaneous coronary intervention-capable centre. We had also planned to evaluate and incorporate sex and gender considerations in the development of our recommendations. Unfortunately, inadequate enrollment of women in randomized trials, lack of publication of main outcomes stratified according to sex, and lack of inclusion of gender as a study variable in the available literature limited the feasibility of such an approach. The Grading Recommendations, Assessment, Development, and Evaluation system was used to develop specific evidence-based recommendations for the early identification of STEMI patients, practical aspects of patient transport, regional reperfusion decision-making, adjunctive prehospital interventions (oxygen, opioids, antiplatelet therapy), and procedural aspects of mechanical reperfusion (access site, thrombectomy, antithrombotic therapy, extent of revascularization). Emphasis is placed on integrating these recommendations as part of an organized regional network of STEMI care and the development of appropriate reperfusion and transportation pathways for any given region. It is anticipated that these guidelines will serve as a practical template to develop systems of care capable of providing optimal treatment for a wide range of STEMI patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect