Research recommendation(s) from an individual piece of guidance
|Guidance||Myocardial infarction with ST-segment elevation: acute management|
|Date issued||July 2013|
Research recommendations coming out of this guidance
- Primary PCI and fibrinolysis in people with acute STEMI who present very early:- If a person with acute STEMI presents within 1 hour of the onset of symptoms, is it better for that person to be given fibrinolysis with a short call to needle time rather than to be transferred to a centre that carries out primary PCI for primary PCI with a delay of up to 120 minutes?
- Primary PCI and fibrinolysis in people with acute STEMI who have a long anticipated transfer time for primary PCI:- In people with acute STEMI who present more than 1 hour after the onset of symptoms, is a primary PCI-related delay of 120–180 minutes associated with outcomes similar to, better or worse than pre-hospital administered fibrinolysis?
- Radial arterial access primary PCI versus femoral arterial access primary PCI:- What is the clinical and cost effectiveness of radial arterial access compared with femoral arterial access for coronary angiography or primary PCI in people with acute STEMI managed by primary PCI?
- Culprit vessel primary PCI versus multivessel PCI:- Does multivessel PCI, at the time of presentation of people with acute STEMI, confer an advantage over a strategy of 'culprit vessel only' primary PCI, followed by further elective revascularisation driven by symptoms and evidence of ischaemia?
- Relationship between volume of procedures and clinical outcomes:- What is the relationship between hospital volume of primary PCI procedures and optimal outcomes in people with acute STEMI?