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Mythsin #ACS 1/5
“Nitroglycerin
is contraindicated in inferior MI 
” Fact: BLS protocols do
differentiate location of #STEMI prior to .Among 821 pts with #STEMI
receiving : 
SBP≥30 mmHg in 23.4% inferior #STEMIs & 23.9% non-inferior #STEMIs, p=0.87
Mythsin #ACS 2/5
”O2 is harmful if given to those with O2Sat>94% presenting w/ACS”Fact: NZOTACS:
and O2 protocols in pts with suspected #ACS had = effect on 30day mortalitySubgroup analysis (take with a grain
) O2 may mortality in #STEMI
Mythsin #ACS 3/5
“IV #morphine in pts w/ #ACS still in pain is safe”: controversial!#morphine
absorption & delays onset #P2Y12 inhibitorsRegistries STEMI SANREMO,FAST-MI,syst review: = outcomes among #ACS pts w/ or w/o morphine.
Time 4 RCT?
https://bit.ly/2XfC4we
Mythsin #ACS 4/5
“In NSTEMI: the sooner PCI is done the better”Fact: VERDICT: #invasive strategy within 4.7 h after dx was
associated with #outcome vs invasive strategy within 2-3 days. Pts with GRACE score >140
outcomes with very early strategy
Mythsin #ACS 5/5
”Never give ticagrelor to a #STEMI pt getting fibrinolytics”Fact: TREAT randomized #STEMI pts receiving #lytics
to ticagrelor or clopidogrel. No difference in major bleeding 
@ 30 days and similar MACE @ 12mo
