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  #1  
Old 06-05-2013
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Heart CCS case confusion!! STEMI

So for NSTMI/UA this is what you use:

abcximab before undergoing angioplasty

for STMI:

you would use clopidogril instead of abcximab. in MTB it says abcximab does not help in STMI. BUT in old archers video he used clopidogril, abcximab, and heparin in the same patient before undergoing angioplasty.
and the reason for using them togeather, he said was theres a better outcome when you use different methods of anticoagulation.

but heparin is not used in STMI!

can some one explain?
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Old 06-05-2013
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someone throw sum light on this
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Old 06-13-2013
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think of the management for STEMI AND NSTEMI like this.....

BOth use........aspirin/b blocker/ nitrates/ heparin (after thrombolytics in STEMI)

NSTEMI use Gp2b3A (meds dont work..urgent angio and PCI)

STEMI uses thrombolytics (PCI is better)


HOpe it helps...Make a table and compare whats different....IT comes down to Thrombolytics (only in STEMI)........gp2b3a (only in NSTEMI)

you play around with PCI and heparin depending on time and procedure
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Old 06-13-2013
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Quote:
Originally Posted by Kais_MD View Post
think of the management for STEMI AND NSTEMI like this.....

BOth use........aspirin/b blocker/ nitrates/ heparin (after thrombolytics in STEMI)

NSTEMI use Gp2b3A (meds dont work..urgent angio and PCI)

STEMI uses thrombolytics (PCI is better)


HOpe it helps...Make a table and compare whats different....IT comes down to Thrombolytics (only in STEMI)........gp2b3a (only in NSTEMI)

you play around with PCI and heparin depending on time and procedure
Just to share some general info..

Heparin and aspirin are given 24 hours AFTER the thrombolytic procedure
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Old 06-13-2013
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You won't use abciximab in STEMI but you will will use clopidogrel. Use it for 9 months if you put a stent as it decreases the chances of restenosis, else I think you use for 1-2 months.


Quote:
Originally Posted by firstaid150 View Post
So for NSTMI/UA this is what you use:

abcximab before undergoing angioplasty

for STMI:

you would use clopidogril instead of abcximab. in MTB it says abcximab does not help in STMI. BUT in old archers video he used clopidogril, abcximab, and heparin in the same patient before undergoing angioplasty.
and the reason for using them togeather, he said was theres a better outcome when you use different methods of anticoagulation.

but heparin is not used in STMI!

can some one explain?
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  #6  
Old 06-14-2013
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STEMI -
Prior to PCI - aspirin + prasugrel or ticagrelor ( if not CI) before PCI + heparin + GP 2b/3A inh (usually not time to start this because u need to cath the pts asap)
you give abciximab for 12 hours after PCI in STEMI.

Discharge medications in STEMI -
aspirin
clopidogrel for 12 mo if stent
b-blocker
statins
ACE-i if EF less than 40 %
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Last edited by Sadde; 06-14-2013 at 04:18 PM.
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Old 06-14-2013
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Quote:
Originally Posted by Sadde View Post
STEMI -
Prior to PCI - aspirin + prasugrel or ticagrelor ( if not CI) before PCI + heparin + GP 2b/3A inh (usually not time to start this because u need to cath the pts asap)
you give abciximab for 12 hours after PCI in STEMI.

Discharge medications in STEMI -
aspirin
clopidogrel for 12 mo if stent
b-blocker
statins
ACE-i if EF less than 40 %
forgot to add that duration of clopidogrel or prasugrel or ticagrelor on discharge depends on which type of stent you use.

DES stent - 12 mo on discharge
BMS stent - 1 mo on discharge.
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  #8  
Old 07-04-2013
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Started CCS cases, how and what are you guys studying? I started with CCS software
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Old 07-04-2013
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Quote:
Originally Posted by XpaezX View Post
Started CCS cases, how and what are you guys studying? I started with CCS software
yoo..Shooot me a msg. when you are free and we'll practice ccs. I think i have the hang of the software and the algorithm. Now its just practice. STill helps to practice with others....
skype: kaisstanazai
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Old 07-04-2013
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Quote:
Originally Posted by Kais_MD View Post
yoo..Shooot me a msg. when you are free and we'll practice ccs. I think i have the hang of the software and the algorithm. Now its just practice. STill helps to practice with others....
skype: kaisstanazai
Will shoot you a PM and will add you once I get a better hold at this, I just started 2hours ago haha
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Old 07-04-2013
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Quote:
Originally Posted by XpaezX View Post
Will shoot you a PM and will add you once I get a better hold at this, I just started 2hours ago haha
lol good luck....its actually fun haha...its like a virtual game
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Old 07-04-2013
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Originally Posted by Kais_MD View Post
lol good luck....its actually fun haha...its like a virtual game
Yes Its quite interesting! I just hope I dont end killing a patient haha
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