ECG Interpretation in Acute Coronary Syndrome – Part I
Dr Ngai-Yin Chan (Hong Kong)
ST-segment elevation myocardial infarction (STEMI) is the most dangerous MI presentation and is distinguished on ECG from other ACS by the distinctive pattern for which it is named. So-called STEMI equivalents refer to MIs which are as dangerous as STEMI, but without characteristic ST elevation. These include Wellens’ syndrome and the de Winter presentation.
Dr Chan educated the audience on the ECG characteristics of the STEMI-equivalent MIs and stressed that familiarity with these conditions may improve triage decision making and encourage the early reperfusion needed in STEMI or STEMI equivalent patients.
Future Perspectives for Antithromotic Strategy after Percutaneous Coronary Intervention (PCI)
Dr Deepak L. Bhatt (USA)
Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 inhibitor is the guideline-recommended cornerstone of antithrombotic management in ACS patients who undergo PCI. Several challenging questions exist regarding P2Y12 inhibitor selection and the optimal duration of DAPT to balance thrombotic and bleeding risk.
Dr Bhatt described how DAPT is important for at least 12 months in medium-to-high-risk patients following PCI. In high-risk patients, such as those with diabetes or complex stenting/extensive disease, a longer duration may be considered if patients tolerated DAPT well. Ticagrelor may be preferred for DAPT durations ≥12 months. A shorter, 3-month course of DAPT followed by monotherapy can be considered for patients with high bleeding risk. Ticagrelor monotherapy is an option in these patients, based on the data of the recent TWILIGHT trial.
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ACS in Action CME Webinar: Connecting with The Experts
On 26 May 2020, the first ACS in Action CME Webinar was held. At this meeting, two presentations on electrocardiogram (ECG) interpretation and antithrombotic treatment following percutaneous coronary intervention (PCI) were given by esteemed local and international faculty.
Duration: 50 minutes