CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI)
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EXPERT CONSENSUS DOCUMENT
CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018 Yukio Ozaki1 · Yuki Katagiri2 · Yoshinobu Onuma1,3 · Tetsuya Amano4 · Takashi Muramatsu1 · Ken Kozuma5 · Satoru Otsuji6 · Takafumi Ueno7 · Nobuo Shiode8 · Kazuya Kawai9 · Nobuhiro Tanaka10 · Kinzo Ueda11 · Takashi Akasaka12 · Keiichi Igarashi Hanaoka13 · Shiro Uemura14 · Hirotaka Oda15 · Yoshiaki Katahira16 · Kazushige Kadota17 · Eisho Kyo18 · Katsuhiko Sato19 · Tadaya Sato20 · Junya Shite21 · Koichi Nakao22 · Masami Nishino23 · Yutaka Hikichi24 · Junko Honye25 · Tetsuo Matsubara26 · Sumio Mizuno27 · Toshiya Muramatsu28 · Taku Inohara29 · Shun Kohsaka29 · Ichiro Michishita30 · Hiroyoshi Yokoi31 · Patrick W. Serruys32 · Yuji Ikari33 · Masato Nakamura34 · The Task Force on Primary Percutaneous Coronary Intervention (PCI) of the Japanese Cardiovascular Interventional Therapeutics (CVIT) Received: 23 February 2018 / Accepted: 27 February 2018 / Published online: 29 March 2018 © The Author(s) 2018
Abstract While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI. Keywords ST elevation acute myocardial infarction · Acute coronary syndrome · Plaque rupture · Plaque erosion · Percutaneous ventricular assist devices · Guideline
Introduction In ST segment elevation myocardial infarction (STEMI), primary PCI has been shown to reduce cardiac events, to convey earlier discharge and to contribute to hemodynamic stabilization in cardiogenic shock and subsequently to become a standard care in Japan [1–19]. Despite a high number of available facilities providing primary PCI in
* Yukio Ozaki ozak
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