American Cardiology of Cardiology/ American Heart Association |
20073838 Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of ACC/AHA. Tas Force on Practice Guidelines (Writing Committee to Revise the 2002 unstable angina non st-elevation myocardial infarction. Circulation. 2007;116(7):e148-304.
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The pretreatment is recommended, although the guideline also present the following sentence: "initiation of clopidogrel may be deferred until a revascularization decision is made" |
20124141 Ineid H, Anderson JL, Wright RS, Adams CD, Bridge CR, Casey DE Jr, et al. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina non-ST elevation myocardial infarction (updating the 2007 Guideline and Replacing the 2011 Focused Update) a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. Circulation.2012;126(7):875-910.
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Patients diagnosed with moderate or high-risk NSTE-ACS should receive dual antiplatelet therapy (pre-catheterization) |
20141212 Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiatis TG, Holmes DR Jr, et al. 2014 AHA/ACC Guideline for the management of patients with non ST-elevation acute coronary syndromes: a report of the ACC/AHA Task Force on Practice Guidelines. Circulation. 2014;130(25):e344-426. Erratum in: Circulation. 2014;130(25):e433-4.
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There is no clear recommendation for DAPT before knowing the coronary anatomy. It recommends a loading with P2Y12 inhibitor in patients who will undergoing PCI with stenting |
20073939 Bassand JP, Hamm CW, Ardissino D, Boersma E, Budai A, Fernandes-Aviles F, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Task Force for Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of European Society of Cardiology. Eur Heart J. 2007;28(13):1598-660.
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"Postponing clopidogrel to after angiography cannot be recommended" |
20104040 Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T, et al. Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2010;31(20):2501-55.
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20114343 Hamm CW, Bassant JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999-3054.
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A P2Y12 inhibitor should be used as soon as possible |
European Society of Cardiology |
20144444 Kolh P, Windecker S, Alfonso F, Collet P, Cremer J, Falk V, et al; Task Force on Myocardial Revascularization of the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery; European Association of Percutaneous Cardiovascular Interventions. 2014 ESC/EACTS guidelines on myocardial revascularization the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Intervention (EAPCI). Eur J Cardiothorac Surg. 2014;46(4):517-92.
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Pretreatment with prasugrel in patients in whom coronary anatomy is not known: class of recommendation III, level of evidence B
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20151313 Roffi M, Patrono C, Collet JP, Mueller C, Vahimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2015 Aug 29. [Epub ahead of print].
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There is a specific session to discuss the best moment for P2Y12 administration, which highlights the controversy of the subject. Since there is no appropriate investigation on clopidogrel and ticagrelor, the guidelines do not specify any recommendation (in favor or against) on pretreatment in early invasive strategy, and do not recommend pretreatment with prasugrel. In conservative approach, P2Y12 inhibitor should be initiated (preferentially ticagrelor) as soon as the diagnosis is confirmed. |
Sociedade Brasileira de Cardiologia |
20133737 Nicolau JC, Timerman A, Marin-Neto JA, Piegas LS, Barbosa CJ, Franci A, et al; Sociedade Brasileira de Cardiologia. Use of demonstrably effective therapies in the treatment of acute coronary syndromes: comparison between different Brazilian regions. Analysis of the Brazilian Registry on Acute Coronary Syndromes (BRACE). Arq Bras Cardiol.2012;98(4):282-9.
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In both, there is no formal recommendation about the best moment for the second antiplatelet agent, and prasugrel is recommended only after the coronary anatomy is known |
20144242 Lorga Filho AM, Azmus AD, Soeiro AM, Quadros AS, Avezum Jr A, Marques AC, et al. Brazilian guidellines on platelet antiaggregants and anticoagulants in cardiology. Arq Bras Cardiol. 2013;101(3 Suppl 3):1-95.
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