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(Circulation. 2008;117:296-329.)
© 2008 American Heart Association, Inc.

STEMI Focused Update

2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the Canadian Cardiovascular Society Endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee

Elliott M. Antman, MD, FACC, FAHA, Co-Chair^*,; Mary Hand, MSPH, RN, FAHA, Co-Chair; Paul W. Armstrong, MD, FACC, FAHA^,; Eric R. Bates, MD, FACC, FAHA; Lee A. Green, MD, MPH^||; Lakshmi K. Halasyamani, MD^¶; Judith S. Hochman, MD, FACC, FAHA^**; Harlan M. Krumholz, MD, FACC, FAHA; Gervasio A. Lamas, MD, FACC^**; Charles J. Mullany, MB, MS, FACC; David L. Pearle, MD, FACC, FAHA; Michael A. Sloan, MD, FACC; Sidney C. Smith, Jr, MD, FACC, FAHA; 2004 Writing Committee Members; Elliott M. Antman, MD, FACC, FAHA, Chair; Daniel T. Anbe, MD, FACC, FAHA; Paul W. Armstrong, MD, FACC, FAHA; Eric R. Bates, MD, FACC, FAHA; Lee A. Green, MD, MPH; Mary Hand, MSPH, RN, FAHA; Judith S. Hochman, MD, FACC, FAHA; Harlan M. Krumholz, MD, FACC, FAHA; Frederick G. Kushner, MD, FACC, FAHA; Gervasio A. Lamas, MD, FACC; Charles J. Mullany, MB, MS, FACC; Joseph P. Ornato, MD, FACC, FAHA; David L. Pearle, MD, FACC, FAHA; Michael A. Sloan, MD, FACC; Sidney C. Smith, Jr, MD, FACC, FAHA; Task Force Members: Sidney C. Smith, Jr, MD, FACC, FAHA, Chair; Alice K. Jacobs, MD, FACC, FAHA, Vice-Chair; Cynthia D. Adams, MSN, PhD, FAHA; Jeffrey L. Anderson, MD, FACC, FAHA; Christopher E. Buller, MD, FACC; Mark A. Creager, MD, FACC, FAHA; Steven M. Ettinger, MD, FACC; Jonathan L. Halperin, MD, FACC, FAHA; Sharon A. Hunt, MD, FACC, FAHA; Harlan M. Krumholz, MD, FACC, FAHA; Frederick G. Kushner, MD, FACC, FAHA; Bruce W. Lytle, MD, FACC, FAHA; Rick Nishimura, MD, FACC, FAHA; Richard L. Page, MD, FACC, FAHA; Barbara Riegel, DNSc, RN, FAHA; Lynn G. Tarkington, RN; Clyde W. Yancy, MD, FACC

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

Preamble...297

1. Introduction...299

   1.1. Evidence Review...299

   1.2. Organization of Committee and Relationships With Industry...299

   1.3. Review and Approval...300

2. Analgesia...300

3. Beta Blockers...300

   3.1. COMMIT/CCS-2 (Metoprolol)...300

   3.2. Conclusion...301

4. Reperfusion...302

   4.1. Logistics of Care...302

5. Facilitated PCI...304

6. Immediate or Emergency Invasive Strategy and Rescue PCI...305

7. PCI After Fibrinolysis or for Patients Not Undergoing Primary Reperfusion...307

   7.1. The Late Open Artery Hypothesis: Clinical Outcomes...307

   7.2. The Late Open Artery Hypothesis: Angiographic Outcomes...308

   7.3. Conclusion...308

8. Ancillary Therapy...308

   8.1. Conclusion...312

9. Thienopyridines...313

   9.1. Conclusion...314

10. Anticoagulants...315

11. Invasive Evaluation...315

12. Secondary Prevention...315

13. Antiplatelet Therapy...320

References...321

Appendix 1...324

Appendix 2...326

	Preamble

 
A primary challenge in the development of clinical practice guidelines is keeping pace with the stream of new data upon which recommendations are based. In an effort to respond more quickly to new evidence, the American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines has created a new "focused update" process to revise the existing guideline recommendations that are affected by evolving data or opinion. Before the initiation of this focused approach, periodic updates and revisions of existing guidelines required up to 3 years to complete. Now, however, new evidence will be reviewed in an ongoing fashion to more efficiently respond to important science and treatment trends that could have a major impact on patient outcomes and quality of care. Evidence will be reviewed at least twice a year, and updates will be initiated on an as needed basis as quickly as possible, while maintaining the rigorous . . . [Full Text of this Article]

Related Internet Resources:

ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary

ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Full Text

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