ACUTE CORONARY SYNDROME – GUIDELINES FOR MANAGEMENT IN SLOVENIA
Keywords:
acute coronary syndrome, treatment, guidelinesAbstract
Background. In this guidelines we present currently accepted doctrine on management of patients with acute coronary syndrome.
Methods. We based our guidelines on European and American Guidelines as well as widely recognized international publications. We have, however, included the specific caracteristics of Slovene medicine, including financial, technical and staff limitations in the treatment of patients with acute coronary syndrome.
Conclusions. Here presented guidelines will provide general information to physicians treating patients with acute coronary syndrome. We however wish to emphasize that the guidelines can only provide basic help in management of patients with acute coronary syndrome and cannot substitute for an individualized approach to each patient. The guidelines will be renewed repeatedly by Center for Intensive Internal Medicine and Clinical Department of Cardiology. In Center for Intensive Internal Medicine a web-site has been created for that purpose (www.intenziva.org), where our current oppinions and doctrine will be available to everybody at any time.
Downloads
References
Davies MJ, Thomas AC. Plaque fissuring: the cause of acute myocardial infarction, sudden ischemic death and crescendo angina. Br Heart J 1985; 53: 363–73.
Fuster V. Mechanisms leading to myocardial infarction: insights from studies of vascular biology. Lewis A. Conner Memorial Lecture. Circulation 1994; 90: 2126–46.
Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995; 92: 657–71.
Antman EM, Braunwald E. Hypertensive and atherosclerotic cardiovascular disease. In: Braunwald E ed. Heart disease. Philadelphia: W. B. Saunders Company, 2001: 995–1421.
Alpert JS, Thygesen K. The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined. – A consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J 2000; 21: 1502–13.
Ryan TJ, Antman EM, Brooks NH et al. ACC/AHA Guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol 1999; 34: 890–911.
Ottesen MM, Kober L, Jorgensen S, Trop-Pedersen C, on behalf of the TRACE study group. Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. Eur Heart J 1996; 17: 429–37.
Newby LK, Rutsch WR, Califf RM et al. Time from symptom onset to treatment and outcomes after thrombolytic therapy. J Am Coll Cardiol 1996; 27: 1646–55.
Goldberg RJ, Mooradd M, Gurwitz JH et al. Impact of time to treatment with tissue plasminogen activator on morbidity and mortality following acute myocardial infarction (The Second National Registry of Myocardial Infarction). Am J Cardiol 1998; 82: 259–64.
Brodie BR, Stuckey TD, Wall TC et al. Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 1998; 32: 1312–9.
Remškar M, Jazbec A, Horvat M, Noč M. Zdravljenje bolnikov z akutnim miokardnim infarktom. Zdrav Vestn 2001; 70: 133–7.
Blohm M, Herlitz J, Hartford M et al. Consequences of a media campaign focusing on delay in acute myocardial infarction. Am J Cardiol 1992; 69: 411–3.
Gaspoz JM, Unger PF, Urban P et al. Impact of public campaign on prehospital delay in patients reporting chest pain. Heart 1996; 76: 150–5.
Gorjup V, Jazbec A, Gersak B. Transtelephonic transmission of electrocardiograms in Slovenia. J Telemed Telecare 2000; 6: 205–8.
Roux S, Christeller S, Ludin E. Effects of aspirin on coronary reocclusion and recurrent ischemis after thrombolysis: a meta-analysis. J Am Coll Cardiol 1992; 19: 671–7.
Hennekens CH, Peto R, Hutchinson GB, Doll R. An overview of the British and American aspirin studies. N Engl J Med 1988; 318: 923–4.
Koren G, Weiss AT, Hasin Y et al. Prevention of myocardial damage in acute myocardial ischemia by early treatment with intravenous streptokinase. N Engl J Med 1985; 313: 1384–9.
Gruppo Italiano per lo Studio della Streptokinasi nell’Infarto Miocardico (GISSI). Effectiveness of intravenous trombolytic treatment in acute myocardial infarction. Lancet 1986; 1: 397–402.
ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction ISIS-2. Lancet 1988; 2: 349–60.
National Heart, Lung, and Blood Institute. Patient/Bystander recognition and action: rapid identification and treatment of acute myocardial infarction. National Heart Atack Alert Program (NHAAP). NIH Publication No. 933303. Bethesda, Md: National Institutes of Health: 1993.
National Heart, Lung, and Blood Institute. 9-1-1: Rapid identification and treatment of acute myocardial infarction. NIH Publication 94-3302. Bethesda, Md: US Department of Health and Human Services, Public Health Service, National Institutes of Health: 1994.
Fibrinolytic Therapy Trialists’ (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and morbidity results from all randomised trials of more than 1000 patients. Lancet 1994; 343: 311–22.
O’Keefe JH, Rutherford BD, McConahay DR et al. Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction. Am J Cardiol 1989; 64: 1221–30.
Zijstra F, de Boer MJ, Hoorntje JC, Reiffers S, Reiber JH, Suryapranata H. A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med 1993; 328: 680–4.
Gibbons RJ, Holmes DR, Reeder GS, Bailey KR, Hopfenspirger MR, Gersh BJ. Immediate angioplasty compared with the administration of a thrombolytic agent followed by conservative treatment for myocardial infarction: the Mayo Coronary Care Unit and Catheterization Laboratory Groups. N Engl J Med 1993; 328: 685–91.
Grines CL, Browne KF, Marco J et al. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction: the Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med 1993; 328: 673–9.
Weaver WD, Simes RJ, Betriu A et al. Comparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review. JAMA 1997; 278: 2093–8.
Lundergan CF, Reiner JS, McCarthy WF, Coyne KS, Califf RM, Ross AM. Clinical predictors of early infarct-related artery potency following thrombolytic therapy: importance of body weight, smoking history, infarct-related artery and choice of thrombolytic regimen: the GUSTO-I experience. J Am Coll Cardiol 1998; 32: 641–7.
Bertrand ME, Simoons ML, Fox KAA, Wallentin LC, Hamm CW, McFadden E, DeFeyter PJ, Specchia G, Ruzyllo W. Task Force Report. Management of acute coronary syndromes: acute coronary syndromes without persistent ST segment elevation. Recommendations of the Task Force of the European Society of Cardiology. Eur Heart J 2000; 21: 1406–32.
Gibbons RJ, Alpert JS, Eagle KA, Faxon DP, Fuster V, Gardner TJ, Gregoratos G, Russel RO, Smith SC. ACC/AHH Guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: executive summary and recommendations. Circulation 2000; 102: 1193–209.
White HD, Van de Werf FJJ. Thrombolysis for acute myocardial infarction. Circulation 1998; 97: 1632–46.
Topol EJ, Moliterno DJ, Herrmann HC et al. Comparison od two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab for the prevention of ischemic events with percutaneous coronary revascularization. N Engl J Med 2001; 344: 1888–94.
Ross AM, Molhoek P, Lundergan C et al. Randomized comparison of enoxaparine, a low-molecular-weight heparin, with unfractionated heparin adjunctive to recombinant tissue plasminogen activator with thrombolysis and aspirin: second trial of heparin and aspirin reperfusion therapy. HART II. Circulation 2001; 104: 648–52.
Ferrario M, Repetto A, Lucreziotti S et al. Low-dose fibrinolytics and glycoprotein IIb/IIIa receptor blockade for the treatment of acute myocardial infarction. Am Heart J 1999; 138: S121–S125.
Topol EJ. Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibitor: the GUSTO V randomised trial. Lancet 2001; 357: 1905–14.
Alter D, Naylor CD, Austin PC, Tu JV. Long-term MI outcomes at hospitals with or without on-site revascularization. JAMA 2001; 285: 2101–8.
DeBoer MJ, Reiber JH, Suryapranata H, van den Brand MJ, Hoorntje JC, Zijlstra F. Angiographic findings and catheterization laboratory events in pts with primary coronary PTCA or streptokinase therapy for acute MI. Eur Heart J 1995; 16: 1347–55.
Gimelli G, Karla A, Sabatine MS, Jang IK. Primary versus rescue percutaneous coronary intervention in patients with acute myocardial infarction. Acta Cardiol 2000; 55: 187–92.
Ellis SG, Da Silva ER, Spaulding CM, Nobuyoshi M, Weiner B, Talley JD. Review of immediate angioplasty after fibrinolytic therapy for acute myocardial infarction. Insight from the RESCUE I, RESCUE II, and other contemporary clinical experiences. Am Heart J 2000; 139: 1046–53.
Wallentin L. Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. FRagmin and fast revascularisation during instability in coronary artery disease (FRISC II) investigators. Lancet 1999; 354: 708–15.
Cannon CP, Weintraub WS, Demopoulos, Vicari R, Frey MJ, Lakkis N, Neumann FJ, Robertson DH, Delucca PT, DiBattiste P, Gibson M, Braunwald E, for the TACTICS-Thrombolysis In Myocardial Infarction 18 Investigators. Comparison of early invasive and conservative strategies in pts with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med 2001; 344: 1879–87.
Eagle KA, Guyton RA, Davidoff R et al. ACC/AHA guidelines for coronary artery bypass graft surgery: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1991 Guidelines for Coronary Artery Bypass graft Surgery). J Am Coll Cardiol 1999; 34: 1262–346.
Cheitlin MD, Alpert JS, Armstrong WF et al. ACC/AHA Guidelines for the clinical application of Echocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practic Guidelines (Committee on Clinical Application of Echocardiography). Developed in collaboration with the American Society of Echocardiography. Circulation 1997; 95: 1686–744.
Kiemeneij F, Serruys PW, Macaya C et al. Continued benefit of coronary stenting versus balloon angioplasty: five-year clinical follow-up of Benestent-I trial. J Am Coll Cardiol 2001; 37: 1598–603.
Eeckhout E, Wijns W, Meier B, Goy JJ. Indications for intracoronary stent placement: the European view. Working Group on Coronary Circulation of the European Society of Cardiology. Eur Heart J 1999; 20: 1014–9.
Macaya C, Serruys PW, Ruygrok P et al. Continued benefit of coronary stenting versus balloon angioplasty: one-year clinical follow-up of Benestnet trial. J Am Coll Cardiol 1996; 27: 255–61.
Mehta SR, Yusuf S, Peters RJ et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI – CURE study. Lancet 2001; 358: 527– 33.
Schwartz SM, de Blois D, O’Brein ERM. The intima – soil of atherosclerosis and restenosis. Circulation Research 1995; 77: 445–65.
Pompa J, Califf R, Topol E. Clinical trials of restenosis after PTCA. Circulation 1991; 84: 1426–36.
Landau C, Lange R, Hillis L. Percutaneous transluminal coronary angioplasty. N Engl J Med 1994; 330: 981–93.
Fuster V, Falk E, Fallon et al. The three processes leading to post PTCA restenosis: dependence on the lesion substrate. Thromb Haemost 1995; 74: 552–9.
The MIAMI Trial Research Group. Metoprolol in acute myocardial infarction: patient population. Am J Cardiol 1985; 56: 1G–57G.
First International Study of Infarct Survival Collaborative Group. Randomized trial of intravenous atenolol among 16027 cases of suspected acute myocardial infarction: ISIS-1. Lancet 1986; 2: 57–66.
GISI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction: Gruppo Italiano per lo Studio della Saprovivenza nell’Infarto Miocardico. Lancet 1993; 343: 1115–22.
ISIS-4: a randomized factorial trial assesing oral captopril, oral mononitrate and intravenous magnesium sulfate in 58050 patients with suspected acute myocardial infarction. Lancet 1995; 345: 669–85.
Sigurdsson A, Swedberg K. Left ventricular remodelling, neurohumoral activation and early treatment with enalapril (CONSENSUS II) following myocardial infarction. Eur Heart J 1994; 15: Suppl B: 14–9.
Ambrosioni E, Borghi C, Magnani B. The effect of the angiotensin-converting-enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction: the Survival of Myocardial Infarction: Long-Term Evaluation (SMILE) Study Investigators. N Engl J Med 1995; 332: 80–5.
Oral captopril versus placebo among 13634 patients with suspected acute myocardial infarction: interim report from the Chinese Cardiac Study (CCS1). Lancet 1995; 345: 686–7.
Anon. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease; the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383–9.
Jackevicius CA, Anderson GM, Leiter L, Tu JV. Use of statins in patients after acute myocardial infarction: does evidence change practice? Arch Intern Med 2001; 161: 183–8.
Maron DJ, Fario S, Linton MF. Current perspectives on statins. Circulation 2000; 101: 207–13.
Schwartz GG, Olsson AG, Ezekowitz MD et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285: 1711–8.
Downloads
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
