Management of ST-elevation myocardial infarction according to European and American guidelines.

AIMS To highlight differences between the most recent guidelines of the European Society of Cardiology (ESC) and the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) on the management of ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS ESC 2012 and ACCF/AHA 2013 guidelines on the management of STEMI were systematically reviewed for consistency. Recommendations were matched, directly compared in terms of class of recommendation and level of evidence, and classified as "identical", "overlapping", or "different". Out of 32 recommendations compared, 26 recommendations (81%) were classified as identical or overlapping, and six recommendations (19%) were classified as different. Most diverging recommendations were related to minor differences in class of recommendation between the two documents. This applies to recommendations for reperfusion therapy >12 hours after symptom onset, immediate transfer of all patients after fibrinolytic therapy, rescue PCI for patients with failed fibrinolysis, and intra-aortic balloon pump use in patients with cardiogenic shock. More substantial differences were observed with respect to the type of P2Y12 inhibitor and duration of dual antiplatelet therapy. CONCLUSIONS The majority of recommendations for the management of STEMI according to ESC and ACCF/AHA guidelines were identical or overlapping. Differences were explained by gaps in available evidence, in which case expert consensus differed between European and American guidelines due to divergence in interpretation, perception, and culture of medical practice. Systematic comparisons of European and American guidelines are valuable and indicate that interpretation of available evidence leads to agreement in the vast majority of topics. The latter is indirect support for the process of review and guideline preparation on both sides of the Atlantic.

The growth of St. Louis children.

Issued as vol. 6, no. 12, Transactions of the Academy of Science of St. Louis.

The well child : a Christmas offering to the children of St. Luke's church, Rochester /

Little Daniel, the good boy: who died in Springfield, Mass.: has separate t.-p.

The diary of Dr. Thomas Cartwright, bishop of Chester; commencing at the time of his elevation to that see, August M.DC.LXXXVI,; and terminating with the visitation of St. Mary Magdalene college, Oxford, October M.DC.LXXXVII.

Mode of access: Internet.

The state of the United Kingdom at the peace of Paris, November 20, 1815 : respecting the people : their domestic energies : their agriculture : their trade : their shipping and their finances.

Mode of access: Internet.

The Edinburgh practice of physic, surgery, and midwifery : preceded by an abstract of the theory of medicine, and the nosology of Dr. Cullen : and including upwards of six hundred authentic formulae from the books of St. Bartholomew's, St. George's, St. Thomas's, Guy's, and other hospitals in London, and from the lectures and writings of the most eminent public teachers.

Mode of access: Internet.

The Edinburgh practice of physic, surgery, and midwifery : preceded by an abstract of the theory of medicine, and the nosology of Dr. Cullen : and including upwards of six hundred authentic formulae from the books of St. Bartholomew's, St. George's, St. Thomas's, Guy's, and other hospitals in London, and from the lectures and writings of the most eminent public teachers.

Mode of access: Internet.

The Edinburgh practice of physic, surgery, and midwifery : preceded by an abstract of the theory of medicine, and the nosology of Dr. Cullen : and including upwards of six hundred authentic formulae from the books of St. Bartholomew's, St. George's, St. Thomas's, Guy's, and other hospitals in London, and from the lectures and writings of the most eminent public teachers.

Mode of access: Internet.

The antient Syriac version of the Epistles of St. Ignatius to St. Polycarp, the Ephesians, and the Romans : together with extracts from his Epistles, collected from the writings of Severus of Antioch, Timotheus of Alexandria, and others : edited with an English translation and notes : also the Greek text of these three Epistles, corrected according to the authority of the Syriac version /

Text in Syriac, Greek and English.

Psalmau Dafydd o'r vn cyfieithiad a'r Beibl cyffredin. The Psalms, tr. into Welsh,

"Rhagnodiadau": p. [7]-10.

The golden Christmas : a chronicle of St. John's, Berkeley, compiled from the notes of a briefless barrister /

Publisher's ads on p. [4] of wrappers.

Funeral oration on the late Hon. Thos. D'Arcy McGee : delivered in the Metropolitan church of St. Mary's, Halifax, Nova Scotia /

Mode of access: Internet.

Encyclopedia of the history of St. Louis : a compedium of history and biography for ready reference /

Paged continuously.

The legend of St. Christopher; a dramatic oratorio, for solo voices, chorus, orchestra, and organ.

Pl. no. 8269.

The life and miracles of St. Wenefrede : together with her litanies ; with some historical observations made thereon.

Attributed to Bishop Wm. Fleetwood.