CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022

Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Interventional and Therapeutics (CVIT) society proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018. Updated guidelines for the management of AMI were published by the European Society of Cardiology (ESC) in 2017 and 2020. Major changes in the guidelines for STEMI patients included: (1) radial access and drug-eluting stents (DES) over bare-metal stents (BMS) were recommended as a Class I indication, (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. In 2020, updated guidelines for Non-ST-Elevation Myocardial Infarction (NSTEMI) patients, the followings were changed: (1) an early invasive strategy within 24 h is recommended in patients with NSTEMI as a Class I indication, (2) complete revascularization in NSTEMI patients without cardiogenic shock is considered as Class IIa recommendation, and (3) in patients with atrial fibrillation following a short period of triple antithrombotic therapy, dual antithrombotic therapy (e.g., DOAC and single oral antiplatelet agent preferably clopidogrel) is recommended, with discontinuation of the antiplatelet agent after 6 to 12 months. Furthermore, an aspirin-free strategy after PCI has been investigated in several trials those have started to show the safety and efficacy. The Task Force on Primary PCI of the CVIT group has now proposed the updated expert consensus document for the management of AMI focusing on procedural aspects of primary PCI in 2022 version.

THE RESULTS OF THE TRIALS OF MICROENCAPSULATED "ENZYMESPORINE" WITH AN ENZYME ON THE PIGS OF SELECTION OF GENESUS

59 терапии воспалительных заболеваний кишечника / И.Л. Халиф [и др.] // Экспериментальная и клиническая гастроэнтерология. – 2013. – № 3. – С. 3-10. 4. Чистяков, В.Т. Современное развитие селекции и генетики в отечественном свиноводстве/ В.Т. Чистяков // Вестник Воронежского государственного аграрного университета. – 2018. – № 4 (59). – C. 71-78. 5. Шевелева, М.А. Современные представления при применении различных групп пробиотических средств при антибиотикотерапии / М.А. Шевелева, Г.А. Равенская // Антибиотики и химоитерапия. – 2009. – Т. 54. – № 3-4. – С. 61-68. 6. Шакиров, Ш.К. Кормовая добавка для свиней / Ш.К. Шакиров, Л.П. Зарипова, Р.Г. Гареев, С.Б. Федоров, М.К. Гайнуллина, Р.С. Сунгатов// Патент на изобретение RU 2147200 С1, МПК A23K1/16; заявка № 98121914/13 от 07.12.1998; опубл. 10.04.2000. 7. Hill, C. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic / C. Hill, F. Guarner, G. Reid [et al.] // Nat Rev Gastroenterol Hepatol. – 2014. – № 11(8). – P. 506–14. 8. Evaluating the efficiency of Enzyme-enriched Enzymesporine probiotic feed additive and its impact on the productive properties of pigs in the fattening process / D.V. Trubnikov [et al.] // IOP Conference Series: Earth and Environmental Science. – 2020. – V. 548. – 082089 – P. 1-6. РЕЗУЛЬТАТЫ ИСПЫТАНИЙ МИКРОКАПСУЛИРОВАННОГО ПРОБИОТИКА «ЭНЗИМСПОРИН» С ФЕРМЕНТОМ НА СВИНЬЯХ СЕЛЕКЦИИ GENESUS Горобец А.Ю., Трубников Д.В. Резюме В статье приведены данные, полученные при проведении научно-хозяйственного опыта по испытанию микрокапсулированного пробиотического препарата «Энзимспорин» с ферментом на свиньях селекции Genesus в условиях современного животноводческого ком-плекса. Результаты исследований показали положительное влияние изученного препарата на приросты живой массы, содержание в крови эритроцитов, гемоглобина, общего белка, аль-буминов, глюкозы, общего кальция, иммуноглобулинов, что свидетельствует об активизации обменных процессов и повышении иммунологического статуса у подопытных свиней. THE RESULTS OF THE TRIALS OF MICROENCAPSULATED "ENZYMESPORINE" WITH AN ENZYME ON THE PIGS OF SELECTION OF GENESUS Gorobets A.Y., Trubnikov D.V. Summary In the article there are presented data that are obtained during the scientific and economic experiment on testing of the microencapsulated probiotic preparation "Enzymesporine" with an en-zyme on pigs of selection of Genesus in conditions of modern livestock complex. The results of the researches showed positive influence of discovered preparation on life weight gains, containing in the blood of erythrocytes, hemoglobin, total protein, albumins, glucose, total calcium, immunoglogulins, that is reveal the intensity of metabolic processes and increasing of immunological status of tested pigs.

Slow VT treatment in a contemporary population of primary prevention ICD recipients

Funding Acknowledgements Type of funding sources: None. Background Implantable cardioverter defibrillator (ICD) is an effective therapy for sudden cardiac death (SCD). 2015 HRS/EHRA/APHRS/SOLAECE expert consensus document suggests long VT detection, above 185 bpm, as optimal ICD programming to reduce unnecessary therapies in primary prevention (PP). Purpose The aim of our study is to evaluate incidence, safety and efficacy of ICD treatment for VT arrhythmias below 185 bpm, in a contemporary population of PP ICD recipients with long detection intervals (LDI), morphological discrimination algorithm and antitachycardia pacing therapies (ATP) before shock. Methods We conducted a single centre retrospective study enrolling 236 patients implanted with a primary-prevention indication from January 2013 to June 2019. Patients were implanted with single or dual chamber single-lead transvenous ICD. All patients had standard device setting with long (at least 20 s in VT and 7 s in VF) VT/VF detection above 150 bpm and therapies starting from 171 with up to 5 ATP and multiple shocks. PainFREE-like bursts and Schaumann-like ramps ATP were always set in VT zone. Of each patient we collected a detailed report of up to five appropriate events and three inappropriate events. Arrhythmia diagnosis was confirmed from 3 independent expert physicians. Date of the event, cycle length, type of morphology (polymorphic or monomorphic), therapies with their effect were collected. Results During a mean follow-up of 42 months, 47 (20 %) and 18 (8%) patients had at least one appropriate and inappropriate activation, respectively. The detailed-events analysis shows that 16 (7%) patients had 38 (30%) appropriate events with rate <188 bpm. At these rate ATP were 97% effective. 14 (38%) of inappropriate activations were caused by arrythmias with ventricular rate below 188 bpm and half of these received a shock; 30% of inappropriate shocks were due to arrhythmia with rate <188 bpm. 73% of treated events, with rate <188 bpm, were appropriate. Only 5.6% (n = 10) of ATP attempts cause arrhythmia acceleration. Conclusions One third of detected arrhythmias had a rate below 188 bpm and 73% were true VT. In this slow VT zone, ATP had a high success rate with low percentage of acceleration.