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2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes
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JACC. September 23, 2014. Accepted Manuscript
DR. JUAN CARLOS BECERRA MARTÍNEZ
Fellow en Cardiología Intervencionista, UMAE HE CMNO
ACC Fellow in-Training
Miembro ESC, EAPCI, SCAI, SOLACI, SOCIME, CCJ
2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes
JACC. September 23, 2014. Accepted Manuscript
Pathophysiology
JACC. September 23, 2014. Accepted Manuscript
Presentation
JACC. September 23, 2014. Accepted Manuscript
TIMI Risk Score
JACC. September 23, 2014. Accepted Manuscript
GRACE Risk Model
JACC. September 23, 2014. Accepted Manuscript
Early Risk Stratification
JACC. September 23, 2014. Accepted Manuscript
Cardiac Biomarkers
JACC. September 23, 2014. Accepted Manuscript
Medical Management
JACC. September 23, 2014. Accepted Manuscript
Medical Management
JACC. September 23, 2014. Accepted Manuscript
Medical Management
JACC. September 23, 2014. Accepted Manuscript
Medical Management
JACC. September 23, 2014. Accepted Manuscript
Aspirin
JACC. September 23, 2014. Accepted Manuscript
P2Y12 Inhibitors
JACC. September 23, 2014. Accepted Manuscript
GP IIb/IIIa inhibitors
JACC. September 23, 2014. Accepted Manuscript
Abciximab: better downstream
Parenteral anticoagulant
JACC. September 23, 2014. Accepted Manuscript
JACC. September 23, 2014. Accepted Manuscript
JACC. September 23, 2014. Accepted Manuscript
Strategies
JACC. September 23, 2014. Accepted Manuscript
Non-anginal pain management
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Special patient groups
JACC. September 23, 2014. Accepted Manuscript
Puntos a discutir…1.- Ya no usar CKMB ni mioglobina en el abordaje diagnóstico
2.- BNP es útil en estratificación
3.- Mejor ticagrelor/prasugrel que clopidogrel
4.- Prasugrel solo si se colocan stents
5.- Mejor eptifibatide/tirofibán que abciximab para terapia “upstream”
6.- Bivalirudina solo en estrategia invasiva
7.- Pacientes con fondoparinux: hacer switch a otro anticoagulante en caso de cateterismo
8.- La estrategia “conservadora inicial” ahora se llama “guiada por isquemia”
Puntos a discutir…9.- Cuatro estrategias de tratamiento:
- Guiada por isquemia (antes conservadora)
- Invasiva Inmediata (2 hrs)
- Invasiva temprana (24 hrs)
- Invasiva tardía (25-72 hrs)
10.- Se añade la pirámide invertida de analgésicos
11.- B-bloqueadores pueden desencadenar espasmo coronario en pacientes con uso reciente de cocaína / metaanfetaminas
12.- Nuevas recomendaciones sobre Takotsubo
Gracias!