Subject: Medical Sciences Book Index: Mechanical Reperfusion for STEMI From Randomized Trials to linical !

ractice St"le: hica#o Manual of St"le$ Indented

% %bciximab administration of earl" therap"$ &'$ &( intracoronar"$ &($ )*+,)** intra-enous$ )*+ periprocedural$ ).,)/$ )' effecti-eness and safet" of$ ' and eptifibatide in STEMI$ && and mortalit" in STEMI$ &0 and primar" ! I$ */ vs. placebo$ randomized trials of$ &1,&. bleedin# complications in$ &/ composite endpoints$ &' coronar" stentin#$ &/ % 2%3% #uidelines de-ices and antithrombotic therapies$ )0'$ )0& lo#istics of care$ )0/$ )0' primar" mechanical reperfusion$ )00,)0( %cute coronar" s"ndromes 4% S5$ *(1 aspirin dose and$ 0. bi-alirudin monotherap"$ ).1 bleedin# risk in$ ).+$ ).) coronar" lesions causin#$ *(1 Euro 3eart Sur-e" 4E3S5$ 0,& patients treated in non6! I hospitals$ 11,1. prasu#rel for$ 0& reperfusion therap"$ 0,& %cute kidne" injur" 4%7I5 risk$ )/*,)/) %cute m"ocardial infarction 4%MI58 See also ST6se#ment ele-ation m"ocardial infarction 4STEMI5 after micro-ascular perfusion$ )*( an#ioplast" in$ /* anterior 9all$ )*' coronar" blood flo9 -elocit" pattern in$ )*&

:ES therap" outcomes in$ **/,**0$ **(,*)+ due to occlusion of left main coronar" arter"$ *.( h"pothermia for$ *0' incidence in 7orea$ /',/0 left -entricular function reco-er" after$ )*0 ;% intra-enous infusion and$ )/1,)/. prehospital thrombol"sis in$ /* and proximal < x occlusion$ */( reperfusion therap" in$ )1/,)1' thrombectom" in manual aspiration catheters$ *..,*./ RT catheter$ *./$ *.0 %djuncti-e mechanical de-ices$ distal embolization pre-ention usin# distal protection de-ices$ *).,*)( in primar" ! I$ *1+ proximal protection de-ices$ *)(,*1+ thrombectom" de-ices8 See Thrombectom" de-ices %:MIR%< trial$ &/ %ir!%MI trial$ *) %lteplase$ 1,.$ **$ *. %merican olle#e of ardiolo#" 4% 52%merican 3eart %ssociation 4%3%5 #uidelines8 See % 2%3% #uidelines %MI3=T randomized trials$ *01 %n#io>uard distal protection de-ice$ *)' %n#ioplast"$ primar" combotherap" and$ ).,)' distal protection de-ices in$ *)0,*)& potential indications for$ *1(,*.+ randomized trials of$ *10,*1( rationale for$ *10 >! IIb2IIIa inhibitor administration abciximab$ )' for pharmacolo#ical facilitation$ )/,)' ischemia time in$ )),)1 ST6se#ment resolution monitorin#8 See ST6se#ment resolution thrombectom" de-ices in$ *)0,*)& %n#ioscop" culprit lesion e-aluation$ *(. functions$ *&( limitation$ *(+ %nticoa#ulation therapies bleedin# complications in$ (/ characteristics of$ (0 distal embolization and$ (/ factor6? inhibitors$ (( lo96molecular69ei#ht heparins$ (&,((

no6reflo9 phenomenon and$ (/ reinfarction and$ (. %ntiplatelet therap"$ 01 aspirin8 See %spirin oral re-ersible !)@*) receptor anta#onist$ &+ oral thrombin receptor anta#onist$ &+ !)@*) inhibitors clopido#rel$ 0.,0& prasu#rel$ 0&,&+ %ntithrombotic therap" % 2%3% #uidelines for$ )0'$ )0& bleedin# risk in$ (/$ ).0 earl" AF3 in$ (( %Bueous ox"#en 4%=5$ animal studies 9ith$ *0) %spiration catheters$ manual$ *..,*./ %spirin ad-erse effects$ 0. interpatient -ariabilit" nonresponders and compliance$ 0. maintenance dose$ 01,0. %SSE;T6. trial$ *. %therosclerotic plaBues$ *(1 ICAS ima#in#$ *&(,*(* = T ima#in#$ *() rupture of$ &1 %utolo#ous BMM; s <CE:C and$ )'. <CEF and$ )'1 mortalit" and$ )'/ %D:'*.+ 4oral re-ersible !)@*) receptor anta#onist5$ &+ B Balloon an#ioplast" cost6effecti-eness anal"sis$ **+ and stentin# in primar" an#ioplast"$ randomized trials of clinical outcome$ *+1 meta6anal"sis$ *+0 selection bias$ *+' Bare metal stent 4BMS5 characteristics of$ *+.,*+/ implantation of$ **. randomized trials of actual6treatment anal"sis$ *+' in acute m"ocardial infarction$ **',**0 limitations of$ *+' randomization strate#ies$ *+' vs. "pher stent implantation$ **',**0

vs. dru#6elutin# stents in acute m"ocardial infarction$ **0 antirestenotic efficac"$ **( lon#6term mortalit"$ *)+ stent thrombosis rate$ **( Bi-alirudin for acute coronar" s"ndromes$ ).1 characteristics of$ (' STEMI treatment 9ith$ (0,(& vs. heparin 9ith >! IIb2IIIa inhibitor$ &(,(+ Bleedin# complications anticoa#ulation dosin# and$ )./ >! IIb2IIIa inhibitors and heparin$ ).' patients at hi#h risk for$ ).' in patient treated 9ith primar" ! I$ *&/ antithrombotic medication$ ).),)./ and blood transfusion$ ).) mortalit" risk$ ).+,).* risk in antithrombotic therap"$ (/ Bod" core temperature and infarct size$ *0/ Bolus a#ents$ . Bone marro9,deri-ed mononuclear cells 4BMM; 5 autolo#ous8 See %utolo#ous BMM; s in -i-o experience 9ith$ )'* BR%CE61 trial$ (+,(* EB"passF model$ /+,/* %:I<<% trial$ &/,&'$ )+&,)+( %!TIM trial$ *. ardiac cell therap" limitations and risks of$ )') in -i-o experience 9ith$ )'* ardiac stem cells$ )'+ ardio#enic shock 4 S5 after STEMI de-elopment of$ *') due to simultaneous subacute stent thrombosis8$ '( emer#enc" re-ascularization for$ '0 hemod"namic support in I%B! therap"$ *'1,*'. mechanical left -entricular support$ *')$ *'0,*'& percutaneous -entricular assist de-ice$ *'.,*'' incidence$ '' in6hospital mortalit" rates of$ *') patient monitorin#$ '' primar" ! I in$ '0,'& ell deli-er"$ methods for$ )'*,)')

ine MRI 4cMR5 dela"ed6enhancement$ ))) of m"ocardial and micro-ascular injur"$ ))) and tissue reperfusion$ ))),))1 lopido#rel loadin# and >! IIb2IIIa inhibition$ (+ loadin# dose and dru#6resistance$ 0/ earl" administration$ 0/ and platelet inhibition$ 0'$ 00 maintenance dose$ 00 oa#ulation cascade$ (' omatose sur-i-ors$ primar" ! I in$ 0+ ombotherap"$ ).,)' ontrast6enhanced ma#netic resonance ima#in#$ ))* dela"ed6enhancement$ ))) of m"ocardial and micro-ascular injur"$ ))) vs. :oppler flo9 -elocit" measurement$ )*( ontrast6induced nephropath" 4 I;5$ in STEMI patients clinical and pro#nostic rele-ance of$ )/+ impact after primar" ! I %7I risk$ )/*,)/) impaired renal function$ )/+ in6hospital mortalit"$ )/* incidence of$ )/* pre-ention techniBues limitation of contrast -olume$ )/.,)/0 pharmacolo#ic a#ents$ )/),)/. ontrast -olume and I; risk$ relation bet9een$ )/.,)/0 limitiation of$ )/0 oronar" an#io#raph"$ )00 coronar" flo9 measurement$ ))(,)1+ patient selection for$ 0+ of patients 9ith STEMI and cardio#enic shock$ '0,'& oronar" an#ioscop"8 See %n#ioscop" oronar" arter"$ li#ation of$ ))* oronar" blood flo9$ measurement of$ )*/ oronar" flo9 -elocit" reser-e 4 FCR5 in infarct6related arter"$ )*',)*0 and left -entricular function after %MI$ )*0 oronar" stentin#8 See also Bare metal stent 4BMS5 abciximab vs. placebo$ &/ after in6stent thrombosis$ (. cost6effecti-eness anal"sis$ **+ outcome in patients$ *+(

in primar" an#ioplast"$ *+(,**+ stent selection and optimization of stent implantation$ *(.,*(/ vs. balloon an#ioplast" in STEMI$ *+0 orrected TIMI frame count 4 TF 5$ )+.,)+/ @!) *( loss6of6function pol"morphism$ 00$ 0& "tochrome !./+ pol"morphism$ 0& : :%;%MI6) trial$ *)$ *1 :i#ital subtraction an#io#raph" 4:S%5$ )+/,)+' :irect stentin# strate#"$ in primar" an#ioplast"$ *+(,**+ :irect thrombin inhibitors$ (' :istal embolization importance of$ *)1,*). incidence of$ (/$ *)1,*). necrotic core -olume in culprit lesion and$ *(1,*(. and perfusion after primar" stentin#$ )+0,)+& and postprocedural TIMI 1 flo9$ *)1$ *)/ pre-ention usin# adjuncti-e mechanical de-ices distal protection de-ices$ *).,*)( proximal protection de-ices$ *)(,*1+ thrombectom" de-ices$ *1+,*11 pro#nostic impact of$ (/ :istal protection de-ices$ *). ad-anta#es and disad-anta#es of$ *)/ characteristics of$ *1& in primar" an#ioplast"8 See :istal protection de-ices in primar" an#ioplast" :istal protection de-ices in primar" an#ioplast" potential indications for$ *1(,*.+ randomized trials of distal occlusi-e de-ices$ *)($ *10$ *.* intracoronar" filters$ *)($ *10,*1&$ *.*,*.) m"ocardial perfusion$ *1& thrombectom" de-ices$ *)0,*)& rationale for$ *10 in ti#ht lesions2proximal tortuosit"$ *.* :oppler flo9 -elocit" measurement$ )*' intracoronar"$ )*0 vs. contrast6enhanced ma#netic resonance ima#in#$ )*( :oppler #uide9ire$ )*/,)*' :ru#6elutin# stent 4:ES5 implantation$ *)+,*)* cost6effecti-eness of$ *)+ late stent thrombosis risk after$ **.,**/ Eoff6labelF indications for$ **. pathoph"siolo#ical considerations$ **.,**/ randomized controlled clinical data

in acute m"ocardial infarction$ **'$ **0 3=RID=;S6%MI stud"$ **& paclitaxel6elutin# stent in STEMI$ **& patient selection$ **',**0 re#istr" data$ **/ safet" concerns$ **. vs. bare metal stents in %MI$ **0 antirestenotic efficac"$ **( lon#6term mortalit"$ *)+ stent thrombosis rate$ **( E Electrocardio#ram 4E >5 in patients 9ith anterior STEMI and #ood perfusion$ )1+ and no6reflo9$ )1* ST6se#ment ele-ation at pre6 and postprocedural$ *(& t9el-e6lead$ )++ Embr"onic stem cells$ )'+ Emer#enc" medical ser-ice$ /+ Endo-ascular coolin# s"stems$ *0/$ *00 Epicardial coronar" arter" patenc"$ restoration of$ ))*$ ))0 Epicardial perfusion assessment approach TF $ )+.,)+/ di#ital subtraction an#io#raph"$ )+/,)+' TF $ )+. TIMI flo9 #rade$ )+1,)+. thrombectom" de-ices and$ *1) Eptifibatide and abciximab for STEMI$ && ES #uidelines on mechanical reperfusion for STEMI$ )0' on ! I$ 00 F Facilitated percutaneous coronar" inter-ention b" abciximab$ ' definition of$ /,' effecti-eness and safet" of$ ',0 b" reduced dose fibrinol"tic a#ent$ ',0 b" thrombol"sis$ *.,*/ Factor6? inhibitors$ (( F%STER trial$ *)( Fibrin6bound thrombin$ (' Fibrinol"sis and stroke risk$ ),1 Fibrinol"tic therap"

in MI patients$ ),. mortalit" reduction b"$ ) randomized trials of$ ),. and reperfusion therap"$ &$ '. vs. primar" ! I$ .,/ FilterGire$ *)' Fondaparinux bleedin# complications associated 9ith$ ).),).1 characteristics of$ (0$ (( postprocedural initiation of$ *++ > >ated sin#le6photon emission computed tomo#raph" 4S!E T5 ad-anta#e of$ )1',)10 importance of$ )1. and m"ocardial sal-a#e$ )10 >l"coprotein adhesion molecules$ (/ >l"coprotein IIb2IIIa inhibitors abciximab8 See %bciximab administration of earl" therap"$ &'$ &( intracoronar"$ &( antiplatelet effects$ &1 choice of$ &' clopido#rel loadin#$ (+ and half6dose$ combination bet9een$ ). 9ith heparin vs. bi-alirudin$ &(,(+ pharmacolo#ical facilitation 9ith$ )/,)' >uideline recommendations % 2%3% #uidelines8 See % 2%3% #uidelines classification$ )0/ ES #uidelines8 See ES #uidelines and outcomes$ link bet9een$ )0. 3 3emorrha#ic stroke8 See Stroke 3eparin and >! IIb2IIIa inhibition vs. bi-alirudin$ &(,(+ preprocedural administration$ (. 3=RID=;S6%MI stud"$ &(,(+$ **& E3ub and spokeF model8 See Interhospital transfer 4I3T5 s"stem 3"perbaric ox"#en 43B=5 in m"ocardial ischemia$ *0+,*0* 3"peroxemic reperfusion after ! I$ *01 9ith aBueous ox"#en$ *0) and infarct size$ *0)

3"pothermia in m"ocardial infarction e-idence for$ *0/ randomized trials of$ *0' ==<6MI trial$ *0/$ *00,*0& I E6IT$ *0& I Impella pump implantation procedure$ *'/ safet"$ feasibilit"$ and efficac" of$ *'' Infarct6related arter" 4IR%5 FCR in$ )*',)*0 distribution in STEMI$ '& recanalization and no6reflo9 phenomenon$ (/ Infarct size$ *0+ and bod" core temperature$ *0/ and h"peroxemic reperfusion$ *0) and left -entricular unloadin#$ *0& scinti#raphic measurement of$ )1/,)1' In6stent thrombosis after coronar" stentin#$ (. determinant of$ *(. Interhospital transfer 4I3T5 s"stem$ /*,/1 Intra6aortic balloon pump 4I%B!5$ *'1,*'. Intracoronar" filters$ *)( Intra-ascular ima#in# an#ioscop" functions of$ *&( limitation of$ *(+ intra-ascular ultrasound 4ICAS5 characterization$ *&( coronar" plaBues$ *(+,*(. culprit lesions$ *(. optical coherence tomo#raph"$ *(*,*() Iodine6*)1,labeled 6meth"liodophen"l pentadecanoic acid 4*)1I6BMI!!5$ )10,)1& Ischemic time and transmural necrosis$ )). 7 7rako9 !ro#ram for the Treatment of M"ocardial Infarction$ 1+$ 1* 7rako9 Re#ion$ STEMI net9orks in cathlabs$ 11 hi#h6risk STEMI patients$ 11 patient transfer routes$ 1+$ 1* primar" ! I ser-ice$ 1*$ 1) re#istries$ 11,1. 9orkshops$ 1.

< <eft -entricular support de-ices Impella pump$ *'' Tandem3eart de-ice$ *'/ <eft -entricular unloadin#$ *0& <inkHpin# Ani-ersit" 3ospital$ STEMI net9orks in ambulance personnel trainin#$ .) mobile E > units$ .) prehospital fibrinol"sis$ .*$ .) treatment strate#" bolus injections of abciximab and heparin$ ./ E > e-aluation$ .1$ .. primar" ! I$ .1$ ./ protocol and reperfusion checklist$ ./$ .',.0 <o96molecular69ei#ht heparins 4<MG3s5 ad-anta#es of$ (& postprocedural initiation of$ *++ randomized trial of$ (&,(( vs. AF3$ (&,(( M Maastricht trial$ **$ *) Mechanical left -entricular 4<C5 support$ *') b" Impella pump$ *'' b" Tandem3eart de-ice$ *'/ Mechanical reperfusion % 2%3% #uidelines on$ )00,)0( factors influencin#$ *)1 impact on m"ocardial perfusion$ )+( 9ith !T %2stentin#$ )+' vs. thrombol"sis$ )0 Mesench"mal stem cells 4MS 5$ )'+ Microemboli micro-ascular d"sfunction$ )1*,)1) Micro-ascular d"sfunction impact of microemboli$ )1*,)1) MRI assessment of$ ))) no6reflo9 phenomenon$ ))( pathoph"siolo#" of$ ))0 T; risk and$ ))),))1 Micro-ascular perfusion$ )+/ after acute m"ocardial infarction$ )*( coronar" blood flo9 patterns in$ )*/$ )*& in patients 9ith TIMI flo9 #rade 1$ )*/ Micro-ascular reperfusion$ detection of$ )*/ Micro-ascular resistance$ (/

M"ocardial blush in patients after !T %$ )+0 predictors of$ )+& M"ocardial contrast echocardio#raph" 4M E5 after reperfusion$ ))&,))( no6reflo9 phenomenon dia#nosis 9ith$ ))0,))& perfusion defect$ ))( M"ocardial infarction 4MI58 See also %cute m"ocardial infarction 4%MI5 incidence of$ /' percutaneous coronar" inter-ention in8 See !ercutaneous coronar" inter-ention 4! I5 reccomendations for prehospital and interhospital transport of patients 9ith$ *0,*& search strate#" and selection criteria for$ ) M"ocardial injur" MRI assessment of$ ))) no6reflo9 phenomenon$ ))( T; risk and$ ))),))1 M"ocardial perfusion and distal embolization durin# primar" ! I m"ocardial blush$ )+0 TIMI61 flo9$ )+'$ )+0,)+& ima#in# modalities coronar" an#io#raph"$ ))(,)1+ TF $ )+.,)+/ di#ital subtraction an#io#raph"$ )+/,)+' #ated S!E T$ )1',)10 ST6se#ment resolution$ )1+,)1* TF $ )+. TIMI flo9 #rade$ )+1,)+. mechanical reperfusion impact on$ )+( pharmacolo#ical therap" impact on$ )+( pre6 and posttreatment assessment of$ )1.,)1/ M"ocardial re#eneration cell deli-er" methods$ )'*,)') cell t"pes for$ )/(,)'* paracrine effects and$ )'* M"ocardial reperfusion assessment approaches nonin-asi-e ima#in# modalities$ )*/ ST6se#ment resolution8 See ST6se#ment resolution causes of$ *10 factors influencin#$ *)1 M"ocardial sal-a#e postreperfusion #ated S!E T and$ )10 pro#nostic implications$ )1/