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CCS case confusion!! STEMI

5K views 11 replies 5 participants last post by  XpaezX 
#1 ·
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?
 
#3 ·
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
 
#4 ·
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 :)
 
#6 · (Edited)
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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