CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2026

Q: What is the clinical evidence from this study?

Study design: Expert Consensus Document. Population: Patients with acute coronary syndromes (ACS) including STEMI, NSTEMI, and unstable angina undergoing PCI in Japan (n=95667). Intervention: Primary percutaneous coronary intervention (PCI) for ACS vs. Conservative strategy or delayed intervention where applicable. Primary outcome: Procedural success defined as residual stenosis <25% and TIMI 3 flow; and in-hospital mortality.

Q: What does this research mean for the field?

Primary PCI for acute coronary syndrome patients in Japan achieves a procedural success rate of 97.4% and an in-hospital mortality of 4.4%, with an average STEMI door-to-balloon time of 84 minutes. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yukio Ozaki; Akihiro Tobe; Yoshinobu Onuma; Kotaro Miyashita; Yoshio Kobayashi; Tetsuya Amano; Hideki Wada; Hideki Ishii; Takashi Muramatsu; Tevfik F. Ismail; Shun Kohsaka; Yoshihisa Nakagawa; Yoshihiro Morino; Shiro Uemura; Kenichi Tsujita; Toshiro Shinke; Junya Ako; Junji Yajima; Thomas Cognet; Junya Shite; Yasumi Igarashi; Nobuo Shiode; Atsunori Okamura; Takayuki Ogawa; Junichi Yamaguchi; Toshihiro Tamura; Takafumi Tsuji; Kentaro Hayashida; Teruyasu Sugano; Ken Saito; Hideki Okayama; Katsuhiro Kawaguchi; Kan Zen; Saeko Takahashi; Kazuhiko Nakazato; Nobuhiro Suematsu; Kiyoshi Hironaga; Tetsuya Matoba; Osamu Iida; Masaharu Ishihara; Masaya Ohta; Masahide Harada; Reina Ozaki; Hideo Izawa; Toyoaki Murohara; Takafumi Ueno; Masato Nakamura; Yuji Ikari; Patrick W. Serruys; Ken Kozuma

doi:10.1007/s12928-025-01229-z

February 26, 2026Cardiovascular Intervention and TherapeuticsOpen Access

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2026

View Full Paper

Ask AI

Bookmark

Share

Figures

Why the study?

New clinical evidence and technological advances emerged since previous versions, prompting an updated expert consensus document on procedural aspects of primary PCI for ACS.

Key Points

Procedural updates establish radial access and selective imaging for primary percutaneous coronary intervention, reducing procedural complications across acute coronary syndromes.
A class III designation opposes routine thrombus aspiration, while complete revascularization within 45 days improves outcomes in acute coronary syndromes.
Expert consensus document synthesizes updated clinical trial evidence, standardizing acute interventions for patients with ST segment elevation myocardial infarction.
Highlights operational standards across catheterization laboratories, which may optimize survival during cardiogenic shock and guide post-procedural dual antiplatelet therapy.

Study Design

Type

Expert Consensus Document (n=95,667)

Multicenter

Yes

Structured PICO

P

Population

Patients with acute coronary syndromes (ACS), including ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndromes (NSTE-ACS), undergoing primary percutaneous coronary intervention (PCI) in Japan.

I

Intervention

Primary percutaneous coronary intervention (PCI) and associated procedural management, including access route, antiplatelet therapy, anticoagulation, and mechanical circulatory support.

This document provides updated 2026 expert consensus recommendations for primary PCI in ACS, specifically tailored to the Japanese clinical context, available pharmacology, and healthcare system.

Limitations

Data primarily from registry and observational sources rather than randomized controlled trials within this document
Limited randomized trial data specific to Japanese population for many procedural aspects
Dose differences in P2Y12 inhibitors between Japan and Europe may affect comparability
Unavailability of GP IIb/IIIa inhibitors in Japan alters treatment context
Some referenced clinical trials were conducted outside Japan and may not directly apply

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Validates contemporary primary PCI outcomes in Japanese ACS; reinforces 2026 expert consensus tailored to local systems and pharmacology.

Abstract

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 Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022 (Ozaki et al. in Cardiovasc Interv Ther 33:178–203, 2018), (Ozaki et al. in Cardiovasc Interv Ther 37:1–34, 2022). Following the publication of the 2023 European Society of Cardiology (ESC) Guidelines for the management of acute coronary syndromes, the CVIT Task Force released another revised version in 2024 (Ozaki et al. in Cardiovasc Interv Ther 39:335–375, 2024). In light of new clinical evidence and technological advances that have emerged since then, the Task Force now proposes an updated expert consensus document for the management of ACS focusing on procedural aspects of primary PCI in 2026 version.

Cite This Study

Ozaki et al. (2026) conducted an expert consensus document in Patients with acute coronary syndromes (ACS) including STEMI, NSTEMI, and unstable angina undergoing PCI in Japan (n=95,667). Primary percutaneous coronary intervention (PCI) for ACS vs. Conservative strategy or delayed intervention where applicable was evaluated on Procedural success defined as residual stenosis <25% and TIMI 3 flow; and in-hospital mortality.

synapsesocial.com/papers/69a286490a974eb0d3c01238 https://doi.org/10.1007/s12928-025-01229-z

View Full Paper

Ask AI

Bookmark

Share

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2026

Figures

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Abstract

Cite This Study

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2026

Figures

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Abstract

Cite This Study

Keep reading

Keep reading