COPYRIGHTED MATERIAL. Index. Ó 2009 John Wiley & Sons, Ltd

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1 Index Figures and Tables are indicated by italic page numbers, Boxes by bold numbers. Abbreviations: ACS ¼ acute coronary syndrome; ECG ¼ electrocardiography; MI ¼ myocardial infarction; PCI ¼ percutaneous coronary intervention; STEMI ¼ ST-segment-elevation myocardial infarction; UA ¼ unstable angina Abciximab 54, 58, 59, 61, 86, 100, 101 Accelerated idioventricular rhythm (AIVR) 87, 164 Access site thrombosis, as complication of angiography/pci 167 Acidosis, in cardiogenic shock, treatment of Acute mitral regurgitation Alcohol consumption Aldosterone receptor blockers for secondary prevention 182, in STEMI 108 trials 185 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on anticoagulant therapy in STEMI 101 2, 156, 190, 191 in UA/NSTEMI 54, 62, 65, 66, 67, 69 on antiplatelet therapy 53 4, 58, 100 conservative compared with early invasive strategies 53 on lipid-lowering therapy 69, 185, 187 on pacemakers 160 1, 162 on percutaneous coronary intervention 89 90, 95 on renin angiotensin aldosterone inhibitors 106, 107, 182 on secondary prevention 174, 182 3, 184 on STEMI management 79, 82, 86, 89, 91, 95, 97, 98, 100, 101 2, 103, 105, 106, 107, 156, 190, 191 on UA/NSTEMI management 37, 42, 53 4, 58, 62, 65, 66, 67, 69 Analgesics 43, 46, 109 Anatomy of heart 212 Angiotensin-converting enzyme (ACE) inhibitors ACC/AHA guidelines 107 for secondary prevention in STEMI trials 180 in UA/NSTEMI 43, 45 6 Angiotensin receptor blockers (ARBs) for secondary prevention 181, 182 in STEMI 107, 108 trials Anterior wall MI bradycardia and AV block 159 ECG 22 3, 161, 209, 210 localizing site of occlusion 22 MRI image 32 in pregnant women 135 timing of hospital discharge Antiarrhythmic agents Antiarrhythmic devices Anticoagulant therapy 9 10 combination with antiplatelet therapy 191 2, 193 in LV intracavitary thrombosis 156 for secondary prevention , in STEMI 101 5, 156 ACC/AHA guidelines 101 2, 156 concurrent with fibrinolysis 85 6, 102 in UA/NSTEMI 39, 61 8 ACC/AHA guidelines 54, 62, 65, 66, 67, 69 Antioxidant vitamins 192 Antiplatelet therapy 9 for secondary prevention in STEMI ACC/AHA guidelines 100 in UA/NSTEMI 39, 49, ACC/AHA guidelines 53 4,58 Antithrombin 8, 9 Anxiolytics 109 Aortic dissection as differential diagnosis of chest pain 15 Apical ballooning syndrome Argatroban 10, 65 Arrhythmic complications of ACS Aspirin 8, 9 ACC/AHA guidelines 53, 174 combinations with clopidogrel 55, 56, 99, 177 warfarin 67 8, 104 5, contraindications 55 desensitization protocol(s) 55, 98, 211 pericarditis treated with 158 for secondary prevention in STEMI 81, 98 in UA/NSTEMI 53, 54 5, 54 COPYRIGHTED MATERIAL Management of Acute Coronary Syndromes Ó 2009 John Wiley & Sons, Ltd Eli V. Gelfand and Christopher P. Cannon

2 218 Index Atenolol 44, 178 Atherosclerotic plaque formation of 2 4 histology 5 rupture of 5 7, 37 Atorvastatin 68, 69, 186, 187 Atrial fibrillation 163 treatment of 105, 190 Atrioventricular block 159 differentiation of site Atrioventricular fistula, as complication of angiography/pci 166 Balloon angioplasty 134 compared with bypass surgery, for diabetics 126 Beta-blockers 43, 44, 105 ACC/AHA guidelines for STEMI 106 diabetics 125 for secondary prevention trials Bezafibrate 188 Bisoprolol 44, 178, 179 Bivalirudin 10, 54, 62, 65 6, 102, Bleeding, complications involving 55, 83, 88, Blood pressure targets 199 Body mass index (BMI) 203 Bradyarrhythmias Bypass surgery, see coronary artery bypass grafting (CABG) Calcium-channel blockers 43, 45, 109 Candesartan 107, 182, 183, 184 Captopril 43, 46, 180 in combination therapy 182, 183, 184 Cardiac biomarkers 26 9 Cardiac chest pain, features associated with 14 Cardiac contusion 137 Cardiac resynchronization therapy 197 Cardiogenic shock due to pump failure circulatory support 144 5, hemodynamically active agents 145, 146 mechanical assist devices 145, 147 clinical presentation 142 etiology 142 prognosis 144 treatment circulatory support 144 5, supportive therapy 145, vicious cycle 143 Cardiovascular examination 19 Cardiovascular magnetic resonance imaging 31, 32, 113, 157 Carvedilol Celexocib 195 Chest discomfort/pain cardiac causes 15, 16 differential diagnosis features associated with 14 features with low likelihood of ACS 15 noncardiac causes 16 noncardiac life-threatening causes Chronic kidney disease (CKD), in ACS patients Citalopram 200 Clopidogrel 8, 9 ACC/AHA guidelines on use 53, 100 combination with aspirin 55, 56, 99, 176 for secondary prevention in STEMI 99, 100 trials 55, 56, 175, 176 in UA/NSTEMI 53, 55 7 Coagulation cascade 8, 9 pharmacologic agents affecting 9 10 Cocaine-associated chest pain ACC/AHA recommended therapies diagnostic and therapeutic strategies 131 Cocaine use, ACS and Cockcroft Gault equation 129 Complications of ACS arrhythmic complications bleeding involved 55, 83, 88, cardiogenic shock due to pump failure fibrinolysis affecting 68, 88 left ventricular aneurysm left ventricular pseudoaneurysm 157 mechanical complications percutaneous coronary intervention affecting pericardial complications right ventricular infarction Computed tomography 30, 31 Conservative strategy 46 7, 48 compared with invasive strategy 47 9 ACC/AHA recommendations 53 trials 50 2 Contrast allergy, as complication of angiography/pci 169 Contrast-induced nephropathy (CIN) 128, 169 preventative measures 128, 169 Cooperative Cardiovascular Project risk model for intracranial hemorrhage 164, 165 Coronary anatomy 212 Coronary angiography complications arising compared with bypass surgery, for diabetics 126 pretreatment with clopidogrel 57 Coronary artery bypass grafting (CABG) 98 for diabetics Coronary artery dissection, as cause of MI during pregnancy 135 Coronary computed tomography 30, 31 Coronary stenting, pretreatment with clopidogrel 57 Coronary vasospasm 10 COX-2 inhibitors C-reactive protein 6 Creatine kinase (CK) 26, 27, 28 Depression, post-mi Development of ACS, processes affecting 1, 2

3 Index 219 Diabetes mellitus, ACS and Diabetics coronary revascularization glycemic control in patients with ACS 125 6, primary ACS therapy Diagnosis (of ACS) cardiac biomarkers 26 9 differential diagnosis 15 16, 133, 134 ECG noninvasive imaging overall diagnostic pathway 32 4 physical examination stress testing 32 Dialysis patients, ACS medications 61, 129 Dietary recommendations Diltiazem 43, 45, 109 Direct thrombin inhibitors 8, 10, 65 6 see also argatroban; bivalirudin; hirudin; lepirudin Dressler s syndrome 158 Dynamic obstruction, development of ACS affected by 10 Echocardiography 29 30, 70 in right ventricular myocardial infarction 149 standard views 213 Electrical storm 163 Electrocardiography (ECG) pathophysiologic basis of ST segment changes in right ventricular myocardial infarction 23, 26, 149, 150 in UA/NSTEMI 26 Emergency department measures 32 3, 42, 82 3, 101 Enalapril 43, 180 Enoxaparin advantages over unfractionated heparin 63 contraindications 65 dosage 65, 103 in STEMI 86, 101, 102 3, 102 trials 63 4 in UA/NSTEMI 62 5 see also low molecular weight heparin (LMWH) Eplerenone 108, 184, 185 Eptifibatide 54, 58, 59 60, 61, 100 contraindication 129 Estrogen replacement therapy 192, 194 Exercise-based therapy 200, 201 Exercise tolerance testing 32, 69, 70 Extracorporeal membrane oxygenation (ECMO) system 145, 147 Ezetimide 187 Factor Xa inhibitor 10, 66, 104 see also fondaparinux Fenofibrate 69 Fibrates, in lipid-lowering therapy 69, 185, 187 9, 188 Fibrinogen 8 Fibrinolysis complications 68, 88 contraindications 68, 83, 84 for STEMI 81 2, 83 8 combined with GPIIb/IIIa inhibitors 86 concurrent anticoagulant therapy 85 6 effectiveness markers 86 8 fibrinolytic agents 85 for UA/NSTEMI 68 compared with PCI 90 3 see also thrombolytic therapy Fish oil 189, 204 Fondaparinux 8, 10, 54, 66 7, 101, 102, 104 Gemfibrozil 69, 187, 188 General appearance of patient Glomerular filtration rate (GFR), estimation of 129 Glycoprotein (GP) IIb/IIIa inhibitors 8, 9 side effects 61 in STEMI in UA/NSTEMI 53, 54, trials see also abciximab; eptifibatide; tirofiban Glycoprotein (GP) IIb/IIIa receptor 8 Hematoma, as complication of angiography/ PCI 166 Hemodynamic calculations 216 Hemodynamic waveforms 216 in RVMI 149, 151 Hemostasis primary 7 8 pharmacologic agents affecting 9 secondary 9 pharmacologic agents affecting 9 10 Heparin LMWH compared with UFH 63 4 low molecular weight (LMWH) 8, 9,54, 62 5, 86, unfractionated (UFH) 8, 9,54, 61 2, 85 6, 101, 102, 102, 156 Heparin-induced thrombocytopenia thrombosis (HITT) syndrome, anticoagulant used 66 Hirudin 65 History Hormone replacement therapy (HRT) 192, 194 Hyperglycemia, treatment of 110, Hypertension, control in secondary prevention 199 Hyperthyroidism, ACS and Hypoxemia, in cardiogenic shock, treatment of 145, 147 Implantable cardioverter defibrillator (ICD) therapy 195 timing of ICD implantation 198 trials Inferior wall MI bradycardia and AV block 159 ECG 23, 162, localizing site of occlusion 24 Inflammation development of ACS affected by 11 marker 6

4 220 Index Influenza vaccination 192 Inotropic agents, in management of cardiogenic shock 145, 146 Intraaortic balloon pump (IABP) 43, 44, 145, 147, 215 Intracranial hemorrhage (ICH) causes 55, 68, 83, 88, 164 emergency treatment of 88, fatality rate 164 risk score 164, 165 Invasive strategy 46, 47 compared with conservative strategy 46 9 ACC/AHA recommendations 53 trials 50 2 see also coronary angiography; percutaneous coronary intervention Ischemic papillary muscle dysfunction 154 Killip classification 142, 143 Kussmaul s sign 149 Left ventricular aneurysm 105, Left ventricular ejection fraction (LVEF) Left ventricular free wall rupture Left ventricular intracavitary thrombosis 156 Left ventricular mural thrombus, treatment of 190 Left ventricular myocardial infarction, symptoms 148 Left ventricular pseudoaneurysm 153, 157 Lepirudin 65 Levine sign 18 Lifestyle recommendations Lipid-lowering therapy for secondary prevention in UA/NSTEMI 68 9 Lisinopril 43, 46 Losartan 182, 183, 184 Low molecular weight heparin (LMWH) 8, 9, 54, 62 5 compared with unfractionated heparin 63 4 in STEMI 86, in UA/NSTEMI 54, 62 5 see also enoxaparin Magnetic resonance imaging 31, 32, 113 Mechanical complications of ACS algorithm for diagnosis and therapy 155 left ventricular free wall rupture Metabolic syndrome ACS and 127, 202 criteria defining 127 Metoprolol 43, 44, 105, 129 Mitral regurgitation Morphine sulfate 43, 46, 109 Myocardial infarction definition(s) 13 14, 28 prehospital management and triage 80 2 transport decisions 82 see also non-st-segment-elevation myocardial infarction (NSTEMI); ST-segment-elevation myocardial infarction (STEMI) Myocardial ischemia 1, 7, 38 pharmacologic treatment of 39, 43 6 Myocardial oxygen balance factors affecting 6 results of imbalance 6, 7,38 Myocardial perfusion imaging 30, 70 Myocarditis 16, Neck examination Nephropathy contrast-induced 128 see also chronic kidney disease (CKD) New-onset angina 38 9 Niacin, in lipid-lowering therapy 69, 185, 188 Nifedipine, avoidance of use 45, 109 Nitrate therapy 44 5, RVMI and 151 Nitroglycerin in STEMI in UA/STEMI 43, 44 5 Noninvasive imaging cardiovascular magnetic resonance imaging 31, 32 coronary computed tomography 30, 31 echocardiography myocardial perfusion imaging 30 Noninvasive risk stratification, predischarge 69 70, 71, Nonsteroidal anti-inflammatory agents (NSAIDs) 158, 194, 195 Non-ST-segment-elevation acute coronary syndromes (NSTEACS), see unstable angina and non-st-segment-elevation myocardial infarction (UA/NSTEMI) Non-ST-segment-elevation myocardial infarction (NSTEMI) 37 Nonsustained ventricular tachycardia Normal coronary arteries, ACS in patients with 132 Omega-3 fatty acids 189, 204 Oral anticoagulants 67 8 Oxygen therapy 46, 111 Pacemakers ACC/AHA guidelines 160 1, 162 permanent temporary transvenous 160 Papillary muscle rupture Pathophysiology (of ACS) 1 11 Percutaneous coronary intervention (PCI) complications arising following fibrinolytic therapy 94 7 ACC/AHA guidelines 95 delayed routine PCI 96 7 facilitated PCI 94 6 rescue PCI 88, 94 compared with coronary artery bypass surgery compared with fibrinolysis 90 3 see also primary PCI

5 Index 221 Perfusion imaging 30, 70 Pericardial complications Pericardial effusion 158 Pericarditis 16, 16, 133 early postinfarction late postinfarction 158 Perindopril 180 Peripartum MI 135 Peripheral vasculature, examination 18 Physical examination non-acs diagnosis 17, 18 Plaque stabilization of 39 see also atherosclerotic plaque Platelet activation 8 Platelet adhesion 7, 8 Platelet aggregation 8 Posterior wall MI bradycardia and AV block 159 ECG 23, 83 Post-hospitalization care lifestyle recommendations limited-benefit medications nonpharmacologic measures pharmacologic measures therapy of comorbidities Postoperative ACS 134 Prasugrel 9, 57 8, Pravastatin 68, 186 Predischarge noninvasive risk stratification 69 70, 71, Pregnancy ACS medications 136 Pregnant women, ACS in Prehospital management and triage, for STEMI 80 2 Primary PCI for STEMI ACC/AHA recommendations GPIIb/IIIa inhibitors used in laboratory pretreatment with clopidogrel 56 7, 99 pretreatment with GPIIb/IIIa inhibitors 101 timing aspects 91 3 see also percutaneous coronary intervention Prizmetal s angina 10 Progressive mechanical obstruction, development of ACS affected by 10 Pseudoaneurysm as complication of angiography/pci 166 left ventricular 153, 157 Pulmonary artery catheter, in management of cardiogenic shock 144 Pulmonary embolism, as differential diagnosis of chest pain 15 Pulmonary examination 19 Pump failure, cardiogenic shock due to Radiation burn, as complication of angiography/pci 169 Radiation therapy, ACS caused by 137 Ramipril 46, 180, 181 Renal failure, as complication of angiography/ PCI Renal function ACS and 128 adjustment of ACS medications 129 Renin angiotensin aldosterone inhibitors 105 8, see also aldosterone receptor blockers; angiotensin-converting enzyme (ACE) inhibitors; angiotensin receptor blockers Reperfusion therapy for STEMI patients factors affecting choice of strategy 93 fibrinolysis 83 8 hospital care following overall strategy 97 primary percutaneous coronary intervention Rest angina 38 Reteplase (rpa) 85 Retroperitoneal bleeding, as complication of angiography/pci 167 Right heart catheterization 149, 216 Right ventricular myocardial infarction (RVMI) causes 148 clinical presentation diagnosis 149, 150 ECG 23, 26, 149, 150 effect of nitrates 108 9, 151 management prognosis 152 Risk factors 17, 173, 174 Risk stratification after STEMI , 156 in UA/NSTEMI 40 2, 69 70, 71 Rofexocib Secondary unstable angina 38, 123 causes 124 development of ACS affected by 11 Sertraline 200 Severe LV dysfunction, anticoagulation therapy Sexual activity after ACS 201 Simvastatin 186, 187 Sinus bradycardia 159 Smoking cessation 201, 202 Spironolactone 184, 185 Statins in combination therapy 69, 188 for secondary prevention 185 7, 188 in UA/STEMI management 68 9 Stent thrombosis 17 Streptokinase (SK) fibrinolysis 85, 104 Stress testing diagnosis of ACS 32 prior to discharge 69 70, 113 safety assessment prior to 113 Stroke as complication of angiography/pci 168 ST-segment-elevation, causes 21, 133

6 222 Index ST-segment-elevation myocardial infarction (STEMI) adjunctive pharmacologic treatment anticoagulation therapy antiplatelet agents coronary artery bypass grafting 98 discharge noninvasive risk stratification ECG 20 6 educational strategy emergency department measures 82 3 global treatment goals 80 1 prehospital management and triage 80 2 reperfusion therapy checklist 84 fibrinolysis 83 8 PCI following fibrinolysis 94 7 primary percutaneous coronary intervention timing of hospital discharge transport decisions 82 Subendocardial ischemia 20 ECG 26 Symptoms, ACS Takotsubo cardiomyopathy 133 Tenecteplase (TNK) 85 Tension pneumothorax, as differential diagnosis of chest pain 16 Thienopyridines 9, 55 8, see also clopidogrel; prasugrel; ticlopidine Thrombin 8 production of 9 role in thrombosis 9 Thrombolytic therapy 68, 81 2, 83 8 contraindications 68, 83, 84 see also fibrinolysis Thrombus formation 1, 7, 8 pharmacologic agents affecting 8, 9 10 Ticlopidine 9, 56 side effect(s) 56 TIMI flow grade(s), as artery-patency marker 86, 87 TIMI Risk Score for STEMI 80, 81 for UA/NSTEMI 41 2 Tirofiban 54, 58, 60, 61, 100 Tissue plasminogen activator (tpa) 85 Trandalopril 180 Transient apical ballooning syndrome Transmural ischemia 20 Transmural necrosis 152, 153 Transport decisions 82 Trauma ACS and 137 Treadmill exercise testing 69, 70 Triage 42, 80 2 Troponin 26, 27, 28 Unfractionated heparin (UFH) 8, 9 in STEMI 85 6, 101, 102, 102, 156 in UA/NSTEMI 54, 61 2 compared with low molecular weight heparin 63 4 Unstable angina and non-st-segment-elevation myocardial infarction (UA/NSTEMI) anticoagulant therapy 39, 61 8 antiplatelet therapy 39, causes 37 8 ECG 26 emergency treatment 42 fibrinolysis 68 general strategies for management lipid-lowering therapy 68 9 overall management pathway 71 pharmacologic treatment of coronary ischemia 39, 43 6 post-discharge care strategies 40 1 predischarge risk stratification 69 70, 71 presentation 38 9 risk stratification of patients 40 2 TIMI Risk Score 41 2 Urokinase 85 Valsartan 107, 182, 183 Ventricular assist devices 145, 147 Ventricular fibrillation 163 Ventricular premature beats Ventricular septal rupture (VSR) Ventricular tachyarrhyhmias 156, treatment of 110, 163 Verapamil 43, 45, 109 Vital signs 18 Vitamins 192 Waist circumference 203 Warfarin 67 8, 104 5, 156, combination with aspirin 67 8, 104, Weight loss recommendations 203 Worsening angina 39 Young patients with ACS 130