ACEI在2013STEMI指南地位.pptxVIP

ACEI在2013版ACC/AHA STEMI指南中的地位主要内容2013版ACC/AHA STEMI指南主要变化ACEI在ACC/AHA STEMI指南中的基石地位FAMIS：第三代ACEI蒙诺在急性心梗中的研究2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction (Journal of the American College of Cardiology). Published on December 17, 2012Developed in Collaboration with American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions? American College of Cardiology Foundation and American Heart Association, Inc.*Patients with cardiogenic shock or severe heart failure initially seen at a non–PCI-capable hospital should be transferred for cardiac catheterization and revascularization as soon as possible, irrespective of time delay from MI onset (Class I, LOE: B). ?Angiography and revascularization should not be performed within the first 2 to 3 hours after administration of fibrinolytic therapy.Reperfusion Therapy for Patients with STEMIIIIIaIIaIIbIIbIIIIIIRegional Systems of STEMI Care, Reperfusion Therapy, and Time-to-Treatment Goals BBAll communities should create and maintain a regional system of STEMI care that includes assessment and continuous quality improvement of EMS and hospital-based activities. Performance can be facilitated by participating in programs such as Mission: Lifeline and the D2B Alliance. Performance of a 12-lead ECG by EMS personnel at the site of FMC is recommended in patients with symptoms consistent with STEMI. Primary PCI in STEMIAdjunctive Antithrombotic Therapy to Support Reperfusion With Primary PCI*The recommended maintenance dose of aspirin to be used with ticagrelor is 81 mg daily.Routine Medical TherapiesRenin-Angiotensin-Aldosterone System InhibitorsIIIIaIIaIIbIIbIIIIIIRenin-Angiotensin-Aldosterone System InhibitorsABAn ACE inhibitor should be administered within the first 24 hours to all patients with STEMI with anterior location, HF, or EF less than or equal to 0.40, unless contraindica