Journal ArticleDOI
Impact of an aggressive invasive catheterization and revascularization strategy on mortality in patients with cardiogenic shock in the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO-I) trial: An observational study
Peter B. Berger,David R. Holmes,Amanda Stebbins,Eric R. Bates,Robert M. Califf,Eric J. Topol +5 more
TLDR
An aggressive strategy of early angiography (and revascularization when appropriate) is associated with a reduction in mortality in patients with acute myocardial infarction and cardiogenic shock who receive thrombolytic therapy.Abstract:
Background Although retrospective analyses have revealed an association between survival and coronary angiography and angioplasty in patients with acute myocardial infarction complicated by cardiogenic shock, the degree to which bias in the selection of patients to undergo these procedures contributes to this observation remains unclear. Methods and Results We studied 2200 patients in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial with acute myocardial infarction complicated by cardiogenic shock (systolic blood pressure <90 mm Hg for ≥1 hour) who survived ≥1 hour after the onset of shock to determine the influence of an aggressive strategy of early angiography (within 24 hours of shock onset) and coronary angioplasty or bypass surgery, if appropriate, on survival. Revascularization was not protocol mandated but was selected by the attending physicians. Shock was present on admission in 11% and developed after admission in 89% of shoc...read more
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Journal ArticleDOI
Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Js. Hochman,La. Sleeper,John G. Webb,Timothy A. Sanborn,Harvey D. White,JD Talley,Christopher E. Buller,Alice K. Jacobs,James Slater,Jacques Col,Sonja M. McKinlay,Thierry H. LeJemtel +11 more
TL;DR: In patients with cardiogenic shock, emergency revascularization did not significantly reduce overall mortality at 30 days, but after six months there was a significant survival benefit, and earlyRevascularization should be strongly considered for patients with acute myocardial infarction complicated by cardiogenesis.
Journal ArticleDOI
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Lee A. Fleisher,Joshua A. Beckman,Kenneth A. Brown,Hugh Calkins,Elliott Chaikof,Kirsten E. Fleischmann,William K. Freeman,James B. Froehlich,Edward K. Kasper,Judy R. Kersten,Barbara Riegel,John F. Robb,Sidney C. Smith,Alice K. Jacobs,Cynthia D. Adams,Jeffrey L. Anderson,Elliott M. Antman,Christopher E. Buller,Mark A. Creager,Steven M. Ettinger,David P. Faxon,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Bruce W. Lytle,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Lynn G. Tarkington,Clyde W. Yancy +30 more
TL;DR: The 2007 Guidelines on Perioperative Cardiovascular Evaluation for Non-Cardiac Surgery (e159-e242) as discussed by the authors were developed by the American College of ACC/AHA Task Force on Practice Guidelines Care for Noncardiac Surgery.
Journal ArticleDOI
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Lee A. Fleisher,Joshua A. Beckman,Kenneth A. Brown,Hugh Calkins,Elliott Chaikof,Kirsten E. Fleischmann,William K. Freeman,James B. Froehlich,Edward K. Kasper,Judy R. Kersten,Barbara Riegel,John F. Robb,Sidney C. Smith,Alice K. Jacobs,Cynthia D. Adams,Jeffrey L. Anderson,Elliott M. Antman,Christopher E. Buller,Mark A. Creager,Steven M. Ettinger,David P. Faxon,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Bruce W. Lytle,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Lynn G. Tarkington,Clyde W. Yancy +30 more
TL;DR: WRITING COMMITTEE MEMBERS Lee A. Fleisher, MD, FACC, FAHA, Chair; Joshua A. Beckman,MD, F ACC¶; Kenneth A. Kasper, MD; Judy R. Kersten,MD; Barbara Riegel, DNSc, RN,FAHA.
Journal Article
[ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery].
TL;DR: ACC/AHA TASK FORCE MEMBERS Sidney C. Smith, Jr, MD, FACC, FAHA, Chair; Alice K. Jacobs, MD., Vice Chair; Cynthia D. Tarkington, RN; Clyde W. Yancy,MD, F ACC.
Journal ArticleDOI
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
Lee A. Fleisher,Joshua A. Beckman,Kenneth A. Brown,Hugh Calkins,Elliot L. Chaikof,Kirsten E. Fleischmann,William K. Freeman,James B. Froehlich,Edward K. Kasper,Judy R. Kersten,Barbara Riegel,John F. Robb +11 more
TL;DR: It is essential that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection, management, or prevention of disease states.
References
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An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.
Maarten L. Simoons,Eric J. Topol,Robert M. Califf,Frans Van de Werf,Paul W. Armstrong,Philip Edmund Aylward,G.I. Barbash,Eric R. Bates,A. Betriu,James Chesebro,J Col,David de Bono,JM Gore,Alan Guerci,John R. Hampton +14 more
TL;DR: The findings of this large-scale trial indicate that accelerated t-PA given with intravenous heparin provides a survival benefit over previous standard thrombolytic regimens.
Journal ArticleDOI
Predictors of 30-Day Mortality in the Era of Reperfusion for Acute Myocardial Infarction Results From an International Trial of 41 021 Patients
Kerry L. Lee,Lynn H. Woodlief,Eric J. Topol,W. Douglas Weaver,Amadeo Betriu,Jacques Col,Maarten L. Simoons,Phil Aylward,Frans Van de Werf,Robert M. Califf +9 more
TL;DR: In this article, the authors performed a comprehensive analysis of relations between baseline clinical data and 30-day mortality and developed a multivariable statistical model for risk assessment in candidates for thrombolytic therapy.
Journal ArticleDOI
TRIAL OF TISSUE PLASMINOGEN ACTIVATOR FOR MORTALITY REDUCTION IN ACUTE MYOCARDIAL INFARCTION: Anglo-Scandinavian Study of Early Thrombolysis (ASSET)
TL;DR: Subset analysis showed that patients who had a normal electrocardiogram (ECG) at the time of randomisation had a low case fatality rate and rt-PA was associated with a 24.5% relative reduction in 1 month fatality.
Journal ArticleDOI
Contemporary reperfusion therapy for cardiogenic shock: The GUSTO-I trial experience
David R. Holmes,Eric R. Bates,Neal S. Kleiman,Neal S. Kleiman,Zygmunt Sadowski,John H. Horgan,Douglas C. Morris,Douglas C. Morris,Robert M. Califf,Robert M. Califf,Peter B. Berger,Peter B. Berger,Eric J. Topol,Eric J. Topol +13 more
TL;DR: Because cardiogenic shock occurred most often after admission and with recurrent ischemia and reinfarction, recognizing signs of incipient shock may improve outcome.