2012 Guidelines of the Taiwan Society of Cardiology (TSOC) for the management of ST-segment elevation myocardial infarction

Yi-Heng Li, Hung I. Yeh, Chia Ti Tsai, Ping-Yen Liu, Tsung Hsien Lin, Tao Cheng Wu, Kuo Chun Hung, Yu Cheng Hsieh, Guang Yuan Mar, Chih Yuan Fang, Kuan Ming Chiu, Jun Jack Cheng, Jyh Hong Chen

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

ST-segment elevation myocardial infarction (STEMI) is one of the most common cardiovascular diseases in Taiwan. The management strategies for STEMI are to do early diagnosis, minimize delay of medical contact, and administration of reperfusion therapy as rapidly as possible. Initial evaluation in emergency department for STEMI includes concise history taking, physical examination, electrocardiogram and cardiac biomarkers measurement. A 12-lead electrocardiogram should be performed within 10 minutes of emergency department arrival. Oxygen, nitroglycerin, analgesia, dual antiplatelet therapy and anticoagulation drugs should be given immediately. Patients with STEMI should receive reperfusion therapy either by primary percutaneous coronary intervention with door-to-balloon time within 90 minutes or by thrombolytic therapy with door-to-needle time within 30 minutes. The pharmacological treatment after admission includes antiplatelet drugs, anticoagulation drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins. STEMI patients should be watched out for hypotension, heart failure or even cardiogenic shock. Mechanical complications, such as acute mitral regurgitation, septum rupture and free wall rupture, cause high mortality after STEMI. Tachy- and bradyarrhythmias are also common in patients with STEMI and should be treated accordingly. Permanent cardiac pacing and implantable cardioverter defibrillator may be necessary after STEMI. Coronary artery bypass grafting surgery may be performed as a definitive or adjunctive revascularization therapy after STEMI. Surgery is also necessary if there are mechanical complications. Before discharge, cardiac rehabilitation should be considered when patients are stabilized. Referral for outpatient rehabilitation should also be encouraged. Antiplatelet drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins should be continued after discharge for secondary prevention. Effective hypertension, diabetes and lipid control are important after STEMI.

Original languageEnglish
Pages (from-to)63-89
Number of pages27
JournalActa Cardiologica Sinica
Volume28
Issue number1
Publication statusPublished - 2012 Mar 1

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Cardiology
Taiwan
Guidelines
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Angiotensin Receptor Antagonists
Platelet Aggregation Inhibitors
Angiotensin-Converting Enzyme Inhibitors
Coronary Artery Bypass
Reperfusion
Hospital Emergency Service
Rupture
Electrocardiography
ST Elevation Myocardial Infarction
Cardiogenic Shock
Implantable Defibrillators
Thrombolytic Therapy
Nitroglycerin
Mitral Valve Insufficiency
Percutaneous Coronary Intervention
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Li, Yi-Heng ; Yeh, Hung I. ; Tsai, Chia Ti ; Liu, Ping-Yen ; Lin, Tsung Hsien ; Wu, Tao Cheng ; Hung, Kuo Chun ; Hsieh, Yu Cheng ; Mar, Guang Yuan ; Fang, Chih Yuan ; Chiu, Kuan Ming ; Cheng, Jun Jack ; Chen, Jyh Hong. / 2012 Guidelines of the Taiwan Society of Cardiology (TSOC) for the management of ST-segment elevation myocardial infarction. In: Acta Cardiologica Sinica. 2012 ; Vol. 28, No. 1. pp. 63-89.
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abstract = "ST-segment elevation myocardial infarction (STEMI) is one of the most common cardiovascular diseases in Taiwan. The management strategies for STEMI are to do early diagnosis, minimize delay of medical contact, and administration of reperfusion therapy as rapidly as possible. Initial evaluation in emergency department for STEMI includes concise history taking, physical examination, electrocardiogram and cardiac biomarkers measurement. A 12-lead electrocardiogram should be performed within 10 minutes of emergency department arrival. Oxygen, nitroglycerin, analgesia, dual antiplatelet therapy and anticoagulation drugs should be given immediately. Patients with STEMI should receive reperfusion therapy either by primary percutaneous coronary intervention with door-to-balloon time within 90 minutes or by thrombolytic therapy with door-to-needle time within 30 minutes. The pharmacological treatment after admission includes antiplatelet drugs, anticoagulation drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins. STEMI patients should be watched out for hypotension, heart failure or even cardiogenic shock. Mechanical complications, such as acute mitral regurgitation, septum rupture and free wall rupture, cause high mortality after STEMI. Tachy- and bradyarrhythmias are also common in patients with STEMI and should be treated accordingly. Permanent cardiac pacing and implantable cardioverter defibrillator may be necessary after STEMI. Coronary artery bypass grafting surgery may be performed as a definitive or adjunctive revascularization therapy after STEMI. Surgery is also necessary if there are mechanical complications. Before discharge, cardiac rehabilitation should be considered when patients are stabilized. Referral for outpatient rehabilitation should also be encouraged. Antiplatelet drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins should be continued after discharge for secondary prevention. Effective hypertension, diabetes and lipid control are important after STEMI.",
author = "Yi-Heng Li and Yeh, {Hung I.} and Tsai, {Chia Ti} and Ping-Yen Liu and Lin, {Tsung Hsien} and Wu, {Tao Cheng} and Hung, {Kuo Chun} and Hsieh, {Yu Cheng} and Mar, {Guang Yuan} and Fang, {Chih Yuan} and Chiu, {Kuan Ming} and Cheng, {Jun Jack} and Chen, {Jyh Hong}",
year = "2012",
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Li, Y-H, Yeh, HI, Tsai, CT, Liu, P-Y, Lin, TH, Wu, TC, Hung, KC, Hsieh, YC, Mar, GY, Fang, CY, Chiu, KM, Cheng, JJ & Chen, JH 2012, '2012 Guidelines of the Taiwan Society of Cardiology (TSOC) for the management of ST-segment elevation myocardial infarction', Acta Cardiologica Sinica, vol. 28, no. 1, pp. 63-89.

2012 Guidelines of the Taiwan Society of Cardiology (TSOC) for the management of ST-segment elevation myocardial infarction. / Li, Yi-Heng; Yeh, Hung I.; Tsai, Chia Ti; Liu, Ping-Yen; Lin, Tsung Hsien; Wu, Tao Cheng; Hung, Kuo Chun; Hsieh, Yu Cheng; Mar, Guang Yuan; Fang, Chih Yuan; Chiu, Kuan Ming; Cheng, Jun Jack; Chen, Jyh Hong.

In: Acta Cardiologica Sinica, Vol. 28, No. 1, 01.03.2012, p. 63-89.

Research output: Contribution to journalReview article

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T1 - 2012 Guidelines of the Taiwan Society of Cardiology (TSOC) for the management of ST-segment elevation myocardial infarction

AU - Li, Yi-Heng

AU - Yeh, Hung I.

AU - Tsai, Chia Ti

AU - Liu, Ping-Yen

AU - Lin, Tsung Hsien

AU - Wu, Tao Cheng

AU - Hung, Kuo Chun

AU - Hsieh, Yu Cheng

AU - Mar, Guang Yuan

AU - Fang, Chih Yuan

AU - Chiu, Kuan Ming

AU - Cheng, Jun Jack

AU - Chen, Jyh Hong

PY - 2012/3/1

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N2 - ST-segment elevation myocardial infarction (STEMI) is one of the most common cardiovascular diseases in Taiwan. The management strategies for STEMI are to do early diagnosis, minimize delay of medical contact, and administration of reperfusion therapy as rapidly as possible. Initial evaluation in emergency department for STEMI includes concise history taking, physical examination, electrocardiogram and cardiac biomarkers measurement. A 12-lead electrocardiogram should be performed within 10 minutes of emergency department arrival. Oxygen, nitroglycerin, analgesia, dual antiplatelet therapy and anticoagulation drugs should be given immediately. Patients with STEMI should receive reperfusion therapy either by primary percutaneous coronary intervention with door-to-balloon time within 90 minutes or by thrombolytic therapy with door-to-needle time within 30 minutes. The pharmacological treatment after admission includes antiplatelet drugs, anticoagulation drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins. STEMI patients should be watched out for hypotension, heart failure or even cardiogenic shock. Mechanical complications, such as acute mitral regurgitation, septum rupture and free wall rupture, cause high mortality after STEMI. Tachy- and bradyarrhythmias are also common in patients with STEMI and should be treated accordingly. Permanent cardiac pacing and implantable cardioverter defibrillator may be necessary after STEMI. Coronary artery bypass grafting surgery may be performed as a definitive or adjunctive revascularization therapy after STEMI. Surgery is also necessary if there are mechanical complications. Before discharge, cardiac rehabilitation should be considered when patients are stabilized. Referral for outpatient rehabilitation should also be encouraged. Antiplatelet drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins should be continued after discharge for secondary prevention. Effective hypertension, diabetes and lipid control are important after STEMI.

AB - ST-segment elevation myocardial infarction (STEMI) is one of the most common cardiovascular diseases in Taiwan. The management strategies for STEMI are to do early diagnosis, minimize delay of medical contact, and administration of reperfusion therapy as rapidly as possible. Initial evaluation in emergency department for STEMI includes concise history taking, physical examination, electrocardiogram and cardiac biomarkers measurement. A 12-lead electrocardiogram should be performed within 10 minutes of emergency department arrival. Oxygen, nitroglycerin, analgesia, dual antiplatelet therapy and anticoagulation drugs should be given immediately. Patients with STEMI should receive reperfusion therapy either by primary percutaneous coronary intervention with door-to-balloon time within 90 minutes or by thrombolytic therapy with door-to-needle time within 30 minutes. The pharmacological treatment after admission includes antiplatelet drugs, anticoagulation drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins. STEMI patients should be watched out for hypotension, heart failure or even cardiogenic shock. Mechanical complications, such as acute mitral regurgitation, septum rupture and free wall rupture, cause high mortality after STEMI. Tachy- and bradyarrhythmias are also common in patients with STEMI and should be treated accordingly. Permanent cardiac pacing and implantable cardioverter defibrillator may be necessary after STEMI. Coronary artery bypass grafting surgery may be performed as a definitive or adjunctive revascularization therapy after STEMI. Surgery is also necessary if there are mechanical complications. Before discharge, cardiac rehabilitation should be considered when patients are stabilized. Referral for outpatient rehabilitation should also be encouraged. Antiplatelet drugs, beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and statins should be continued after discharge for secondary prevention. Effective hypertension, diabetes and lipid control are important after STEMI.

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