ACS/AMI III Flashcards Preview

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Flashcards in ACS/AMI III Deck (25):
1

until how many days post MI do troponins remain elevated?

10d

2

Sn of troops 6h after onset of CP?

65%

3

which biomarker can quantitate the size of an infarct?

CK

4

CK onset, peak, normalization

6-10h after MI onset
peaks at 1d
resolves in 2-3d

5

causes of CKMB increase besides MI

CRF
GU/GI dz or Sx
marathons

6

how long after sxs onset does CKMB2 reliably rise?

6h

7

which trial made ASA in STEMI a Class I indication? (esp w/ A/C)

ISIS-2

8

what did meta-analysis show for primary PCI vs/ thrombolysis in STEMI

decrease mortality with PCI

9

if the STEMI sxs onset is <3h from arrival to ED, what is preferred strategy (PCI vs fibrinolysis)?

no preference unless contraindication or compelling indication (like Killip class III--> PCI)

10

Absolute contraindications to fibrinolytic Rx

ICH
ischemic CVA within 3 mo's
significant facial/head trauma within 3 mo's
known brain lesion
suspected Ao dissection
active bleeding

11

wich fibrinolytic agent has the relatively best 90 min latency and TIMI 3 flow rates?

TNK

12

what are the only benefits of DES in STEMI?

less restenosis
less TVR at 1 yr

13

which trial (by G. Stone) showed that Taxus DES had significantly less TLR c/t BMS?

HORIZONS-AMI

14

which trial showed that there is no benefit to mortality with DES vs BMS?

HORIZONS-AMI

15

does aspiration thrombectomy in STEMI improve survival?

yes

16

which trial showed that there was no benefit to PCI of a totally occluded artery (c/w OMT)?

OAT

17

should you routinely transfer STEMI patients for PCI after TNK fibrinolysis? Which trial addressed this?

Yes!
TRANSFER-AMI

18

Name 3 subgroups that have atypical presentations or STEMI

women,elderly, diabetics

19

In Keeley's metanalysis, what was the on,y disadvantage of PCI over thrombolysis?

PCI had more major bleeding

20

What do the new STEMI guidelines say about 90 mins?

It's FIRST MEDICAL CONTACT to DEVICE TIME

21

If pt with STEMI comes to non-PCI center, how long can the FCM-device time be including transfer?

120min

22

What is an absolute contraindications specific to streptokinase?

Prior streptokinase in last 6 months

23

Is recent, internal bleeding an absolute contraindications to fibrinolytic therapy in STEMI?

No, relative

24

Which fibrinolytic agent has the most fibrin specificity?

TNK

25

Which fibrinolytic agent has the least fibrin specificity?

Streptokinase