Diabetics, Elderly, Women, CABG

ST elevation myocardial infarction

Other ACS

• Diabetics: CABG may be preferred for multi-vessel disease in diabetics
• Elderly are managed similarly to non-elderly
• Women are treated similarly to men
• Post-CABG status
  • One indication for early angiography
  • Stress testing with imaging (IIa)
• Variant angina with episodic chest pain and ST-segment elevation should undergo coronary angiography

Circulation.1999;100:1016
Circulation.2004;110:588

Circulation.2000;102:1193 Circulation.2002;106:1893

Cocaine users

ST elevation myocardial infarction

Other ACS

• Nitroglycerine and calcium blockers for ST segment deviation
• Immediate coronary angiography for persistent ST elevation. Thrombolysis if clot is demonstrated
• Beta blockers for hypertension (SBP > 150) or tachycardia (HR > 100) (IIa)
• Coronary angiography for persistent ST-segment depression/T-wave inversion after GTN/Ca Blockers IIa)
• Thrombolysis for persistent ST-segment elevation after GTN/Ca blockers if PTCA not available (IIa)

• Coronary angiography in patients without ST-T changes

Circulation.1999;100:1016
Circulation.2004;110:588

Circulation.2000;102:1193 Circulation.2002;106:1893