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Acute Myocardial Infarction Research
Research Guide
What is Acute Myocardial Infarction Research?
Acute Myocardial Infarction Research is the body of scientific studies focused on the diagnosis, management, and treatment of acute myocardial infarction, including ST-segment elevation myocardial infarction, troponin assays, thrombolytic therapy, primary angioplasty, risk assessment, and guidelines for acute coronary syndromes.
The field encompasses 78,176 published works on topics such as ST-segment elevation, primary angioplasty, troponin assays, thrombolytic therapy, and risk scores for cardiovascular disease. Key contributions include ESC and ACC/AHA guidelines that standardize management protocols for patients presenting with ST-segment elevation or non-ST-segment elevation acute coronary syndromes. Research also evaluates antiplatelet therapies and cholesterol-lowering interventions post-myocardial infarction.
Topic Hierarchy
Research Sub-Topics
ST-Elevation Myocardial Infarction Guidelines
This sub-topic develops and updates evidence-based ESC and ACC/AHA guidelines for STEMI management, focusing on timely reperfusion and antithrombotic therapy. Researchers evaluate guideline adherence and outcomes in real-world registries.
Primary Percutaneous Coronary Intervention
This sub-topic compares primary PCI versus thrombolysis for STEMI, assessing door-to-balloon times, radial access, and stent innovations. Clinical trials analyze long-term patency and complication rates.
Troponin Assays in Acute Coronary Syndromes
This sub-topic evaluates high-sensitivity troponin for early NSTEMI/STEMI diagnosis, risk stratification, and serial measurement protocols. Studies address assay variability, cutoffs, and integration with imaging.
Dual Antiplatelet Therapy in ACS
This sub-topic investigates P2Y12 inhibitors like ticagrelor, prasugrel, and clopidogrel added to aspirin in ACS, balancing ischemic and bleeding risks. Landmark trials inform duration and potency recommendations.
Risk Stratification in Acute Myocardial Infarction
This sub-topic develops GRACE and TIMI risk scores incorporating biomarkers, ECG, and clinical factors to predict AMI mortality and complications. Validation studies refine scores for personalized management.
Why It Matters
Acute Myocardial Infarction Research directly informs clinical guidelines that reduce mortality and improve outcomes in heart attack patients. For instance, "2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation" by Ibáñez et al. (2017) provides evidence-based recommendations adopted across Europe, influencing reperfusion strategies like primary angioplasty. Similarly, "Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes" by Wallentin et al. (2009) demonstrated ticagrelor reduced vascular death, myocardial infarction, or stroke rates without increasing overall major bleeding, guiding antiplatelet therapy in over 6960 cited instances. "The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels" by Sacks et al. (1996) showed cholesterol-lowering benefits extend to patients with average levels, impacting post-infarction care in cardiology practice.
Reading Guide
Where to Start
"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation" by Ibáñez et al. (2017), as it provides a comprehensive, evidence-based overview of diagnosis, reperfusion, and management protocols most cited in the field with 9496 citations.
Key Papers Explained
Ibáñez et al. (2017) in "2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation" builds on earlier ESC guidelines like Steg et al. (2012) "ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation" by updating ST-elevation management recommendations. Roffi et al. (2015) "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation" complements this by addressing non-ST-elevation cases. Wallentin et al. (2009) "Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes" and Wiviott et al. (2007) "Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes" provide trial evidence on antiplatelets integrated into these guidelines, while Sacks et al. (1996) "The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels" establishes secondary prevention strategies.
Paper Timeline
Most-cited paper highlighted in red. Papers ordered chronologically.
Advanced Directions
Recent guidelines like Knuuti et al. (2019) "2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes" extend acute research to chronic management, focusing on plaque modification via lifestyle and interventions. No preprints or news from the last 12 months indicate stable frontiers in guideline refinement and therapy optimization.
Papers at a Glance
Frequently Asked Questions
What are the key recommendations in ESC guidelines for ST-segment elevation myocardial infarction?
The "2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation" by Ibáñez et al. (2017) recommend primary angioplasty as the preferred reperfusion therapy when available within recommended times. They emphasize rapid diagnosis using ECG and troponin assays. These guidelines reflect evidence from scientific knowledge available at publication, with 9496 citations.
How does ticagrelor compare to clopidogrel in acute coronary syndromes?
"Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes" by Wallentin et al. (2009) found ticagrelor reduced rates of death from vascular causes, myocardial infarction, or stroke compared to clopidogrel. This held for patients with or without ST-segment elevation. Major bleeding rates did not increase overall, supporting ticagrelor use with 6960 citations.
What is the role of statins after myocardial infarction?
"The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels" by Sacks et al. (1996) demonstrated pravastatin reduces coronary events in patients with average cholesterol post-infarction. Benefits extend to the majority of coronary disease patients. The study has 7461 citations.
What do guidelines say for non-ST-segment elevation acute coronary syndromes?
The "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation" by Roffi et al. (2015) outline risk stratification and antithrombotic therapies. They recommend invasive strategies based on risk scores. The guidelines have 8224 citations.
How does diabetes affect myocardial infarction risk?
"Mortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial Infarction" by Haffner et al. (1998) showed diabetic patients without prior infarction have myocardial infarction risk equal to nondiabetics with prior infarction. This supports aggressive risk factor treatment in diabetics. The paper has 7014 citations.
What are the effects of prasugrel versus clopidogrel?
"Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes" by Wiviott et al. (2007) reported prasugrel reduced ischemic events including stent thrombosis in patients scheduled for percutaneous coronary intervention. It increased major bleeding risk, including fatal bleeding. Overall mortality was unchanged, with 6661 citations.
Open Research Questions
- ? What are the long-term outcomes of ticagrelor versus prasugrel in diverse patient populations beyond trial settings?
- ? How can risk scores be refined to better predict mortality in diabetic patients post-myocardial infarction?
- ? What optimal timing and combinations of reperfusion therapies minimize complications in ST-segment elevation cases?
- ? In patients with average cholesterol, which statin regimens best prevent recurrent coronary events?
- ? How do guideline updates incorporate new antiplatelet data to balance ischemic and bleeding risks?
Recent Trends
The field has accumulated 78,176 works, with highly cited guidelines dominating, such as Ibáñez et al. at 9496 citations and Antman et al. (2004) "ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary" at 8361 citations.
2017Evolution shows progression from early antiplatelet trials like Yusuf "Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-Segment Elevation" (6446 citations) to advanced agents in Wallentin et al. (2009) and Wiviott et al. (2007).
2001No recent preprints or news coverage in the last 12 months reported.
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