Download - 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes
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JACC. September 23, 2014. Accepted Manuscript
DR. JUAN CARLOS BECERRA MARTÍNEZ
Fellow en Cardiología Intervencionista, UMAE HE CMNO
ACC Fellow in-Training
Miembro ESC, EAPCI, SCAI, SOLACI, SOCIME, CCJ
2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes
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JACC. September 23, 2014. Accepted Manuscript
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Pathophysiology
JACC. September 23, 2014. Accepted Manuscript
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Presentation
JACC. September 23, 2014. Accepted Manuscript
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TIMI Risk Score
JACC. September 23, 2014. Accepted Manuscript
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GRACE Risk Model
JACC. September 23, 2014. Accepted Manuscript
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Early Risk Stratification
JACC. September 23, 2014. Accepted Manuscript
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Cardiac Biomarkers
JACC. September 23, 2014. Accepted Manuscript
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Medical Management
JACC. September 23, 2014. Accepted Manuscript
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Medical Management
JACC. September 23, 2014. Accepted Manuscript
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Medical Management
JACC. September 23, 2014. Accepted Manuscript
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Medical Management
JACC. September 23, 2014. Accepted Manuscript
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Aspirin
JACC. September 23, 2014. Accepted Manuscript
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P2Y12 Inhibitors
JACC. September 23, 2014. Accepted Manuscript
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GP IIb/IIIa inhibitors
JACC. September 23, 2014. Accepted Manuscript
Abciximab: better downstream
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Parenteral anticoagulant
JACC. September 23, 2014. Accepted Manuscript
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JACC. September 23, 2014. Accepted Manuscript
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JACC. September 23, 2014. Accepted Manuscript
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Strategies
JACC. September 23, 2014. Accepted Manuscript
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Non-anginal pain management
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Special patient groups
JACC. September 23, 2014. Accepted Manuscript
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Puntos a discutir…1.- Ya no usar CKMB ni mioglobina en el abordaje diagnóstico
2.- BNP es útil en estratificación
3.- Mejor ticagrelor/prasugrel que clopidogrel
4.- Prasugrel solo si se colocan stents
5.- Mejor eptifibatide/tirofibán que abciximab para terapia “upstream”
6.- Bivalirudina solo en estrategia invasiva
7.- Pacientes con fondoparinux: hacer switch a otro anticoagulante en caso de cateterismo
8.- La estrategia “conservadora inicial” ahora se llama “guiada por isquemia”
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Puntos a discutir…9.- Cuatro estrategias de tratamiento:
- Guiada por isquemia (antes conservadora)
- Invasiva Inmediata (2 hrs)
- Invasiva temprana (24 hrs)
- Invasiva tardía (25-72 hrs)
10.- Se añade la pirámide invertida de analgésicos
11.- B-bloqueadores pueden desencadenar espasmo coronario en pacientes con uso reciente de cocaína / metaanfetaminas
12.- Nuevas recomendaciones sobre Takotsubo
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Gracias!