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CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022. 2022
Yukio Ozaki, and
Hironori Hara, and
Yoshinobu Onuma, and
Yuki Katagiri, and
Tetsuya Amano, and
Yoshio Kobayashi, and
Takashi Muramatsu, and
Hideki Ishii, and
Ken Kozuma, and
Nobuhiro Tanaka, and
Hitoshi Matsuo, and
Shiro Uemura, and
Kazushige Kadota, and
Yutaka Hikichi, and
Kenichi Tsujita, and
Junya Ako, and
Yoshihisa Nakagawa, and
Yoshihiro Morino, and
Ichiro Hamanaka, and
Nobuo Shiode, and
Junya Shite, and
Junko Honye, and
Tetsuo Matsubara, and
Kazuya Kawai, and
Yasumi Igarashi, and
Atsunori Okamura, and
Takayuki Ogawa, and
Yoshisato Shibata, and
Takafumi Tsuji, and
Junji Yajima, and
Kaoru Iwabuchi, and
Nobuo Komatsu, and
Teruyasu Sugano, and
Masaru Yamaki, and
Shinichiro Yamada, and
Hiroaki Hirase, and
Yuusuke Miyashita, and
Fuminobu Yoshimachi, and
Masakazu Kobayashi, and
Jiro Aoki, and
Hirotaka Oda, and
Yoshiaki Katahira, and
Kinzo Ueda, and
Masami Nishino, and
Koichi Nakao, and
Ichiro Michishita, and
Takafumi Ueno, and
Taku Inohara, and
Shun Kohsaka, and
Tevfik F Ismail, and
Patrick W Serruys, and
Masato Nakamura, and
Hiroyoshi Yokoi, and
Yuji Ikari, and
Department of Cardiology, Fujita Health University School of Medicine, Aichi, Japan. yukio.ozaki7@gmail.com.
Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Interventional and Therapeutics (CVIT) society proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018. Updated guidelines for the management of AMI were published by the European Society of Cardiology (ESC) in 2017 and 2020. Major changes in the guidelines for STEMI patients included: (1) radial access and drug-eluting stents (DES) over bare-metal stents (BMS) were recommended as a Class I indication, (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. In 2020, updated guidelines for Non-ST-Elevation Myocardial Infarction (NSTEMI) patients, the followings were changed: (1) an early invasive strategy within 24 h is recommended in patients with NSTEMI as a Class I indication, (2) complete revascularization in NSTEMI patients without cardiogenic shock is considered as Class IIa recommendation, and (3) in patients with atrial fibrillation following a short period of triple antithrombotic therapy, dual antithrombotic therapy (e.g., DOAC and single oral antiplatelet agent preferably clopidogrel) is recommended, with discontinuation of the antiplatelet agent after 6 to 12 months. Furthermore, an aspirin-free strategy after PCI has been investigated in several trials those have started to show the safety and efficacy. The Task Force on Primary PCI of the CVIT group has now proposed the updated expert consensus document for the management of AMI focusing on procedural aspects of primary PCI in 2022 version.
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