Korean Circ J.  2020 Oct;50(10):845-866. 10.4070/kcj.2020.0196.

2020 Korean Society of Myocardial Infarction Expert Consensus Document on Pharmacotherapy for Acute Myocardial Infarction

• Kim HK
• Ahn Y
• Chang K
• Jeong YH
• Hahn JY
• Choo EH
• Kim MC
• Kim HS
• Kim W
• Cho MC
• Jang Y
• Kim CJ
• Jeong MH
• Chae SC
• Korean Society of Myocardial Infarction

• KMID: 2507003
• DOI: http://doi.org/10.4070/kcj.2020.0196

Abstract

Clinical practice guidelines published by the European Society of Cardiology and the American College of Cardiology/American Heart Association summarize the available evidence and provide recommendations for health professionals to enable appropriate clinical decisions and improve clinical outcomes for patients with acute myocardial infarction (AMI). However, most current guidelines are based on studies in non-Asian populations in the pre-percutaneous coronary intervention (PCI) era. The Korea Acute Myocardial Infarction Registry is the first nationwide registry to document many aspects of AMI from baseline characteristics to treatment strategies. There are well-organized ongoing and published randomized control trials especially for antiplatelet therapy among Korean patients with AMI. Here, members of the Task Force of the Korean Society of Myocardial Infarction review recent published studies during the current PCI era, and have summarized the expert consensus for the pharmacotherapy of AMI.

Keyword

Myocardial infarction; Drug therapy

Figure

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  Figure 1 Unique ischemic and bleeding tendency and pharmacokinetics of P2Y12 receptor inhibitors in East Asian population. This figure was modified from the original version.53)CV = cardiovascular; ICAS = intracranial atherosclerosis; MI = myocardial infarction.

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  Figure 2 Subgroup analyses of East Asians from randomized control trials about acute coronary syndrome. This figure was modified from the original version.53)ACS = acute coronary syndrome; AMI = acute myocardial infarction; CI = confidence interval; DAPT = dual antiplatelet therapy; HR = hazard ratio; COMMIT/CCS-2 = Clopidogrel and Metoprolol in Myocardial Infarction Trial/Second Chinese Cardiac Study; CURRENT/OASIS-7 = Clopidogrel Optimal Loading Dose Usage to Reduce Recurrent EveNTs/Optimal Antiplatelet Strategy for InterventionS-7; PCI = percutaneous coronary intervention; PHILO = Study to Assess Safety and Efficacy of Ticagrelor Versus Clopidogrel in Asian/Japanese Patients With Non-ST or ST Elevation Acute Coronary Syndrome; PRASFIT-ACS = PRASugrel compared with clopidogrel For Japanese patIenTs with ACS undergoing PCI; STEMI = ST segment elevation myocardial infarction; TRILOGY-ACS = TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes.

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  Figure 3 Scoring system for predicting overall benefit from the use of potent P2Y12 receptor inhibitors. This figure was modified from the original version.58)Cr = serum creatinine; LVEF = left ventricular ejection fraction; MI = myocardial infarction; STEMI = ST segment elevation myocardial infarction.

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