Implementation of clinical practices and pathways optimizing ACS patients lipid management: Focus on eight European initiatives.

Post-acute coronary syndrome (ACS) patients are at very high cardiovascular risk. Despite current guidelines strongly recommend to reduce LDL-C levels and initiation of high-intensity statins as early as possible in patients admitted with an ACS, less than half of ACS patients receive a high intensity statin, and a high percentage of has LDL-C well above the goal despite therapy. There are multiple reasons for that, including physician lack of guideline adherence, patient lack of compliance with treatment, and lack of standardized procedures.

Percutaneous left main coronary disease treatment without on-site surgery back-up in patients with acute coronary syndromes: immediate and 2-year outcomes.

Background: Best revascularization strategy in patients with acute coronary syndromes (ACS) and unprotected left main (ULM) coronary disease is still debate reflecting lack of convincing data.

Objectives: To assess clinical feasibility and efficacy of ULM percutaneous coronary intervention (PCI) in patients with ACS and describe the practice of a center without on-site surgical back-up over a 7-year period.

Methods: Data on high-risk patients with ACSs undergoing percutaneous ULM treatment were prospectively collected in an independent registry.

Primary angioplasty and routine utilization of thrombus aspiration devices: feasibility and results in a consecutive series of 486 patients.

Background: Primary percutaneous transluminal coronary angioplasty (PTCA) is the treatment of choice for acute ST-segment elevation myocardial infarction (STEMI) in high-volume centres with experienced operators, but is often limited by a suboptimal microvascular perfusion due to distal embolization and impaired myocardial perfusion. The present study investigates whether routine use of thrombus aspiration (TA) devices is feasible in daily practice, along with its safety and effectiveness.

Methods: This study is based on a series of 486 consecutive STEMI patients treated at our single institution by the same three operators (from 2001 to 2005).