This editorial refers to ‘One-year outcomes after a strategy using enoxaparin vs. unfractionated heparin in patients undergoing fibrinolysis for ST-segment elevation myocardial infarction: 1-year results of the ExTRACTTIMI 25 trial’, by D.A. Morrow et al., on page 2097 and ‘Relations between bleeding and outcomes in patients with ST-elevation myocardial infarction in the ExTRACT-TIMI 25 trial’,...

Highlights of 2020 publications on acute cardiac care–acute coronary syndromes. The statements in this figure are based individual published articles and do not represent any kind recommendation. ACS, syndrome; CABG, artery bypass grafting; COVID-19, coronavirus disease 19; DAPT, dual antiplatelet therapy; FFR, fractional flow reserve; I/R, ischaemia–reperfusion; IRA, infarct-related artery; MI...

OBJECTIVES Despite the recommendations to initiate β-blockade to all patients with an ST-segment elevation myocardial infarction, data concerning the timing of the administration of β-blockers are controversially discussed. In view of these controversies, we analyzed the effect of immediate vs. delayed β-blockade on all-cause mortality of patients with ST-segment elevation myocardial infarction...

An issue, which is not addressed by the guidelines, is whether, in the absence of Sgarbossa’s criteria, the association of acute coronary syndrome (ACS) type chest pain and left bundle branch block (LBBB) falls within the province of non-ST segment elevation ACS (nSTE-ACS) or whether it falls within the province of acute myocardial infarction. Strictly speaking, it is only when Sgarbossa’s crit...

ST-segment elevation during exercise testing has been attributed to myocardial ischemia and wall motion abnormalities (WMA). However, the functional significance of ST-segment elevation during dobutamine stress testing (DST) has not been evaluated in patients referred for diagnostic evaluation of myocardial ischemia. DST (up to 40 micrograms/kg/min) with simultaneous echocardiography and techne...

BACKGROUND Although animal studies have documented metformin's cardioprotective effects, the impact in humans remains elusive. The study objective was to explore the association between metformin and myocardial infarct size in patients with diabetes presenting with ST-segment elevation myocardial infarction. METHODS AND RESULTS Data extraction used the National Cardiovascular Data CathPCI Reg...

INTRODUCTION AND OBJECTIVES A variable percentage of patients with myocardial infarction treated with successful primary angioplasty and restoration of coronary flow show persistent ST-segment elevation, probably due to inadequate cellular reperfusion. We studied if persistent ST-segment elevation was a predictor of worse prognosis. PATIENTS AND METHODS We comparatively studied the clinical a...

BACKGROUND Coronary microvascular dysfunction is frequently seen in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention. Previous studies have suggested that the administration of intravenous adenosine resulted in an improvement of myocardial perfusion and a reduction in infarct size. Intracoronary adenosine (bolus of 30 to 60 microg) is a guideline...

Acute coronary syndromes are usually classified on the basis of the presence or absence of ST elevation on the ECG: ST-elevation myocardial infarction or non-ST-elevation myocardial infarction (NSTEMI)patients with acute myocardial infarction (AMI) need immediate therapy, without unnecessary delay and primary percutaneous coronary intervention (PPCI) should preferably be performed within 90 min...

BACKGROUND The main causes of late (>1 month) stent thrombosis (ST) are stent uncoverage, malapposition, and neoatherosclerosis. First-generation drug-eluting stents were associated with higher rate of late ST compared with bare-metal stents (BMS), especially in patients with ST-segment-elevation myocardial infarction. Second-generation everolimus-eluting stents (EES) have shown similar rate of...