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CHAPTER SUMMARY AND CENTRAL ILLUSTRATION
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FIRE Trial
The FIRE trial was an international, multicenter, randomized, superiority trial comparing the efficacy of physiology-guided complete revascularization versus culprit-only revascularization in older patients (≥ 75 years) with acute myocardial infarction (MI) and multivessel coronary artery disease. Read More
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ABYSS Trial: Beta-Blocker Interruption or Continuation after Myocardial Infarction
Though beta-blockers are routinely prescribed post myocardial infarction, their long-term benefit in patients with preserved function (LVEF >40%) is uncertain. Read More
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AEGIS-II Trial: Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction
This phase 3 randomized, placebo-controlled trial assessed the efficacy and safety of CSL112, a human plasma-derived apolipoprotein A1 that increases cholesterol efflux capacity, in high-risk patients (multivessel coronary artery disease, and pharmacologic treatment of diabetes or two additional risk factors: age 65 years or older, history of MI, peripheral artery disease) after acute myocardial infarction (MI). Read More
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EMPACT-MI Trial Review
The EMPACT-MI investigators evaluated whether the addition of empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, to the standard treatment for acute myocardial infarction (AMI) affected future mortality or heart failure (HF) in at-risk patients. Read More
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ECLS-SHOCK Trial Review
The ECLS-SHOCK trial evaluated the impact of extracorporeal life support (ECLS) on mortality in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. Read More
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OCT versus IVUS versus angiography guidance: a real-time updated network meta-analysis
This network meta-analysis comprised 20 randomized trials of percutaneous coronary intervention (PCI) guided by intravascular imaging (IVI) compared with angiography guidance alone. Read More
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BIOVASC: Immediate Versus Staged Complete Revascularization in ACS and Multivessel Disease
The BIOVASC trial was a prospective, open-label, non-inferiority, randomized, multinational clinical trial designed to assess whether immediate versus staged (within 6 weeks after the index procedure) complete revascularization improves outcomes in patients with acute coronary syndromes (ACS) and multivessel coronary disease. Read More
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SECURE Trial
The SECURE trial is an open-label, multinational trial that randomized 2,499 patients aged ≥65 years with a prior type 1 myocardial infarction (MI) within the 6 months preceding enrollment to a polypill-based strategy with a single pill containing aspirin (100 mg), ramipril (2.5, 5 or 10 mg) and atorvastatin (20 or 40 mg), or to usual care. Read More
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PACMAN-AMI: Effects of the PCSK9 Antibody Alirocumab on Coronary Atherosclerosis in Patients with Acute Myocardial Infarction
The PACMAN-AMI trial sought to evaluate effects of PCSK9 inhibition on atherosclerotic plaque progression via serial intracoronary imaging of non-culprit plaques in patients presenting with acute myocardial infarction (MI) on high-intensity statin therapy. Read More
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Chapter Summary
This chapter discusses the pathophysiology, epidemiology, diagnosis, and treatment of non–ST-segment elevation acute coronary syndromes (see Fuster and Hurst’s Central Illustration). The most common etiology is disruption of an atherosclerotic coronary ...