title: ACC/AHA guideline update for the management of ST-segment elevation myocardial infarction.
abstract: The American College of Cardiology and American Heart Association, in collaboration with the Canadian Cardiovascular Society, have issued an update of the 2004 guideline for the management of patients with ST-segment elevation myocardial infarction. The American Academy of Family Physicians endorses and accepts this guideline as its policy. Early recognition and prompt initiation of reperfusion therapy remains the cornerstone of management of ST-segment elevation myocardial infarction. Aspirin should be given to symptomatic patients. Beta blockers should be used cautiously in the acute setting because they may increase the risk of cardiogenic shock and death. The combination of clopidogrel and aspirin is indicated in patients who have had ST-segment elevation myocardial infarction. A stepped care approach to analgesia for musculoskeletal pain in patients with coronary heart disease is provided. Cyclooxygenase inhibitors and nonsteroidal anti-inflammatory drugs increase mortality risk and should be avoided. Primary prevention is important to reduce the burden of heart disease. Secondary prevention interventions are critically important to prevent recurrent events in patients who survive.
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
authors.forename: Denise L
authors.initials: DL
authors.lastname: Campbell-Scherer
authors.forename: Lee A
authors.initials: LA
authors.lastname: Green
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D017115:Catheter Ablation; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005081:Exercise Therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D055502:Secondary Prevention; D016540:Smoking Cessation; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin