PMID- 18574277
OWN - NLM
STAT- MEDLINE
DCOM- 20080826
LR  - 20170602
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 133
IP  - 6 Suppl
DP  - 2008 Jun
TI  - Acute ST-segment elevation myocardial infarction: American College of Chest 
      Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
PG  - 708S-775S
LID - S0012-3692(08)60129-4 [pii]
LID - 10.1378/chest.08-0665 [doi]
AB  - This chapter about fibrinolytic, antiplatelet, and antithrombin treatment for 
      acute ST-segment elevation (STE) myocardial infarction (MI) is part of the 
      American College of Chest Physicians Evidence-Based Clinical Practice Guidelines 
      (8th Edition). Grade 1 recommendations are strong and indicate that the benefits 
      do, or do not, outweigh risks, burden, and costs. Grade 2 suggests that 
      individual patient values may lead to different choices (for a full understanding 
      of the grading see the chapter by Guyatt et al, CHEST 2008; 
      133[suppl]:123S-131S). Among the key recommendations in this chapter are the 
      following: for patients with ischemic symptoms characteristic of acute MI of < or 
      = 12 h in duration and persistent STE, we recommend that all undergo rapid 
      evaluation for reperfusion (primary percutaneous coronary intervention [PCI] or 
      fibrinolytic) therapy and have a reperfusion strategy implemented promptly after 
      contact with the health-care system (Grade 1A). For patients with ischemic 
      symptoms characteristic of acute MI of < or = 12 h in duration and persistent 
      STE, we recommend administration of streptokinase, anistreplase, alteplase, 
      reteplase, or tenecteplase over no fibrinolytic therapy (all Grade 1A). For 
      patients with symptom duration < or = 6 h, we recommend the administration of 
      alteplase or tenecteplase over streptokinase (both Grade 1A). We recommend 
      aspirin over no aspirin therapy followed by indefinite therapy (Grade 1A); we 
      also recommend clopidogrel in addition to aspirin for up to 28 days (Grade 1A). 
      In addition to aspirin and other antiplatelet therapies, we recommend the use of 
      antithrombin therapy (eg, unfractionated heparin (UFH), enoxaparin, or 
      fondaparinux) over no antithrombin therapy (Grade 1A), including for those 
      patients receiving fibrinolysis (and regardless of which lytic agent is 
      administered), primary PCI, or patients not receiving reperfusion therapy.
FAU - Goodman, Shaun G
AU  - Goodman SG
AD  - Michael's Hospital, University of Toronto, and Canadian Heart Research Centre, 
      Toronto, ON, Canada. Electronic address: goodmans@smh.toronto.on.ca.
FAU - Menon, Venu
AU  - Menon V
AD  - Cleveland Clinic Foundation, Cleveland, OH.
FAU - Cannon, Christopher P
AU  - Cannon CP
AD  - Brigham and Women's Hospital, Boston, MA.
FAU - Steg, Gabriel
AU  - Steg G
AD  - Hopital Bichat, Paris, France.
FAU - Ohman, E Magnus
AU  - Ohman EM
AD  - Duke University Medical Center, Durham, NC.
FAU - Harrington, Robert A
AU  - Harrington RA
AD  - Duke University Medical Center, Durham, NC.
LA  - eng
PT  - Journal Article
PT  - Practice Guideline
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
EIN - Chest. 2008 Oct;134(4):892
MH  - Angioplasty, Balloon, Coronary
MH  - Aspirin/administration & dosage/therapeutic use
MH  - Electrocardiography
MH  - *Evidence-Based Medicine
MH  - Fibrinolytic Agents/administration & dosage/*therapeutic use
MH  - Humans
MH  - Myocardial Infarction/diagnosis/*drug therapy/therapy
MH  - Platelet Aggregation Inhibitors/administration & dosage/*therapeutic use
MH  - Risk Assessment
MH  - Risk Factors
EDAT- 2008/07/24 09:00
MHDA- 2008/08/30 09:00
CRDT- 2008/07/24 09:00
PHST- 2008/07/24 09:00 [pubmed]
PHST- 2008/08/30 09:00 [medline]
PHST- 2008/07/24 09:00 [entrez]
AID - S0012-3692(08)60129-4 [pii]
AID - 10.1378/chest.08-0665 [doi]
PST - ppublish
SO  - Chest. 2008 Jun;133(6 Suppl):708S-775S. doi: 10.1378/chest.08-0665.