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Antiplatelet and Anticoagulant Drugs for ST-elevation Myocardial Infarction (STEMI)

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    Overview and Recommendations

    • Background

    • Management

  • Related Summaries

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    Aspirin

    • Recommendations for aspirin in STEMI

    • Administration

    • Efficacy evidence

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    P2Y12 Inhibitors and Dual Antiplatelet Therapy (DAPT)

    • General information

    • Duration of Dual Antiplatelet Therapy (DAPT)

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      Recommendations from professional organizations

      • American College of Cardiology/American Heart Association (ACC/AHA) guidelines

      • European Society of Cardiology (ESC) recommendations on dual antiplatelet therapy (DAPT) in coronary artery disease

      • American College of Chest Physicians (ACCP) guidelines (Ninth Edition)

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      Clopidogrel

      • Efficacy of clopidogrel

      • Efficacy of clopidogrel based on dose

      • Duration of clopidogrel

      • Proton pump inhibitors and clopidogrel

    • Prasugrel

    • Ticagrelor

    • Cangrelor

    • Comparative efficacy of P2Y12 inhibitors

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    Glycoprotein IIb/IIIa Antagonists

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      Use with percutaneous coronary intervention (PCI)

      • Recommendations with primary PCI

      • Efficacy with primary PCI

      • Comparative efficacy among IV GP IIb/IIIa inhibitors

      • Combination of GP IIb/IIIa inhibitor plus thrombolytic for PCI

      • Intracoronary abciximab

      • Upstream GP IIb/IIIa inhibitor use

    • Use with thrombolytics

    • Discontinuation in coronary artery bypass (CABG) patients

    • Use in chronic kidney disease

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    Anticoagulants

    • Recommendations for anticoagulants in STEMI

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      Heparins

      • Unfractionated heparin

      • Low-molecular-weight heparin

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      Fondaparinux

      • Classification

      • Efficacy

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      Direct Thrombin Inhibitors

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        Bivalirudin

        • Bivalirudin versus heparin plus glycoprotein IIb/IIa inhibitors

      • Hirudin

    • Factor Xa inhibitors

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

  • Risk for Bleeding

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    Quality Improvement

    • Physician Quality Reporting System Quality Measures

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    Guidelines and Resources

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      Guidelines

      • United States guidelines

      • United Kingdom guidelines

      • Canadian guidelines

      • European guidelines

      • Asian guidelines

    • Review articles

  • Patient Information

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    ICD Codes

    • ICD-10 codes

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    References

    • General references used

    • Recommendation grading systems used

    • Synthesized Recommendation Grading System for DynaMed

    • DynaMed Editorial Process

    • Special acknowledgements

    • How to cite

Recommendations Editor
Amir Qaseem MD, PhD, MHA, FACP
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Affiliations

Vice President of Clinical Policy, American College of Physicians; Pennsylvania, United States; President Emeritus, Guidelines International Network; Germany

Conflicts of Interest

Dr. Qaseem declares no relevant financial conflicts of interest.

Deputy Editor
Peter Oettgen MD
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Affiliations

Editor in Chief, DynaMed; Cardiologist, Beth Israel Deaconess Medical Center; Massachusetts, United States; Associate Professor of Medicine, Harvard Medical School; Massachusetts, United States

Conflicts of Interest

Dr. Oettgen declares no relevant financial conflicts of interest.

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