2005年美国心脏学会心肺复苏和心血管急救指南（中文版）.pdfVIP

CARDIOLOGY/SPECIAL CONTRIBUTION 2007 Update to the ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction: Implications for Emergency Department Practice Charles V. Pollack, Jr, MA, MD From the Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA (Pollack); and the TIMI Eugene Braunwald, MD Study Group, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (Braunwald). The American College of Cardiology and American Heart Association have updated their guidelines for the management of non–ST-segment-elevation acute coronary syndrome for the first time since 2002. In the interim, several important studies affecting choices of therapy potentially begun in the emergency department have been completed, and care patterns have changed and matured significantly. In this review, we present the new recommendations that are pertinent to emergency medicine practice and comment on their potential implementation into an evidence-based, multidisciplinary approach to the evaluation and management of this challenging patient population. [Ann Emerg Med. 2008;51: 591-606.] 0196-0644/$-see front matter Copyright © 2008 by the American College of Emergency Physicians. doi:10.1016/j.annemergmed.2007.09.004 INTRODUCTION DEFINITIONS AND WEIGHTING OF EVIDENCE The American College of Cardiology (ACC) and the Non–ST-segment-elevation acute coronary syndrome American Heart Association (AHA) have jointly published comprises a clinical syndrome that presents as anginal chest pain practice guidelines for various aspects of cardiovascular disease or its equivalent (eg, dyspnea, jaw or arm p