MD Conference Express ACC 2012 - (Page 8)
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F E A T U R E
Treatment of AMI in the Post-Herrick Era
Written by Rita Buckley
Cardiovascular leader and innovator Eugene Braunwald, MD, MACC, Harvard Medical School, Boston, Massachusetts, USA, launched The Legends of Cardiovascular Medicine series by delivering the 2012 Simon Dack Lecture, which focused on the treatment of acute myocardial infarction (AMI) – into the second century after Herrick. The lecture delved into the early gains that were made in the treatment of AMI, noting that the field has changed dramatically since 1912, when James B. Herrick, MD, postulated that thrombosis in the coronary artery leads to the symptoms and abnormalities that are associated with heart attacks [Herrick JB. JAMA 1912]. Dr. Braunwald covered the major advances over the subsequent 100 years and provided a vision for cardiovascular medicine in the coming century. Myocardial Infarction: The Early Days Early pioneers in cardiovascular medicine were faced with a highly lethal disease, as patients with myocardial infarction (MI) experienced a 30% in-hospital mortality rate or frequently died before they could get to a hospital. The first major therapeutic advance occurred in 1961, with Dr. Desmond Julian’s creation of the coronary care unit [Julian DG. Lancet 1961] which segregated patients with AMI, carefully monitored them with alarms, and performed closed chest resuscitation of previously fatal arrhythmias. This development reduced the mortality rate by half. Other breakthroughs have included reperfusion therapy, which has been associated with a 75% decrease in mortality over a 25-year period; the addition of aspirin therapy to the MI treatment regimen; balloon angioplasty; and the use of both bare-metal and drug-eluting stents. These advances have continued to make impressive reductions in the mortality rate, but MI still exacts a high toll in morbidity and mortality in the United States (US) and around the world. A Relentless Foe Official Highlights From the Even with these impressive gains, MI remains a major health concern, with almost 1 million new cases a year in the US alone. An American citizen experiences an MI approximately every 34 seconds, and the attack will be fatal about 15% of the time [Roger VL et al. Circulation 2012]. The estimated annual incidence of MI among Americans is 610,000 new attacks and 325,000 recurrent ones; the annual mortality rate is 134,000. Worldwide, the figures are even more staggering. Every year, 17.1 million lives—82% of which are in the developing world—are claimed by the global burden of cardiovascular disease (CVD) [World Heart Federation. State of the Heart Cardiovascular Disease Report 2012].
ACC-i2
with
innovation in intervention
March 24 – 27, 2012 • CHICAGO
Exhibits: March 24 – 26
8
May 2012
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Table of Contents for the Digital Edition of MD Conference Express ACC 2012
MD Conference Express ACC 2012
Table of Contents
Treatment of AMI in the Post-Herrick Era
The State of Hypertension Guidelines: 2012
ACRIN PA 4005: Coronary CTA in the ED Identifies Low-Risk Patients and Shortens Length of Stay
One-Year STAMPEDE Trial Results
TAVR Associated with Increased Late Mortality from Paravalvular Regurgitation
The CABG Surgery Off- or On- Pump- Revascularization Study (CORONARY)
The Moderate PE Treated with Thrombolysis Study (MOPETT)
Pacemaker Therapy In Patients With Neurally Mediated Syncope and Documented Asystole
Outcomes from the BRIDGE-ACS Trial
ROMICAT II: More Data Evaluating CT-First for Acute Chest Pain ED Triage
Elective PCI at Community Hospitals With Versus Without On-Site Surgery
Results from the TRA 2P-TIMI 50 Trial
The HOST-ASSURE Randomized Trial
New Monoclonal Antibody to PCSK9 Markedly Lowers LDL-C in Patients on Atorvastatin
Oral Rivaroxaban Alone for Symptomatic PE
Neutral Outcomes But Important Insights From FOCUS-CCTRN
Imaging
STEMI
Acute Coronary Syndrome
Antiplatelet Therapy
New Anti-Diabetes Agents Offer Promise in the Fight Against CVD
The New Hypertrophic Cardiomyopathy Practice Guidelines
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