AHA ACC与ESC STEMI相关指南更新.pptVIP

STEMI现代观点与临床实践—AHA/ACC与ESC相关指南更新 2010 ESC: Antithrombotic treatment options in myocardial revascularization 2010 ESC: Antithrombotic treatment options in myocardial revascularization 2011 ESC Recommendations for oral antiplatelet agents in NSTE-ACS 2011 ESC Recommendations for GP IIb/IIIa receptor inhibitors in NSTE-ACS 2011 ESC Recommendations for anticoagulants in NSTE-ACS 2011 ESC Recommendations for Criteria for high risk, invasive evaluation andrevascularization in NSTE-ACS 2011 ESC Recommendations for diagnosis and risk stratification of CP * May be useful in STEMI patients with short ischemic times and large clot burdens * * ?For example, small vessels, long lesions, or diabetes mellitus. This recommendation applies to primary and nonprimary PCI patients with STEMI. * *Immediate catheterization/angiography is recommended for unstable patients. * Mehta SR, Granger CB, Boden WE, et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009;360:2165-75 *Further exclusion criteria in supplemental appendix in NEJM * Kaplan–Meier Cumulative Risk of the Primary and Secondary Outcome at 6 Months. Panel A shows the cumulative risk of the composite primary outcome of death, MI, or stroke in the early-intervention group, as compared with the delayed-intervention group, with a nonsignificant between-group difference (P = 0.15) Trial underpowered- Subgroup analysis (high-risk subset) of this overall negative trial was not robust and must be viewed cautiously Mehta SR, Granger CB, Boden WE, et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009;360:2165-75 * Kaplan–Meier Cumulative Risk of the Primary and Secondary Outcome at 6 Months. Panel B shows the risk of the composite secondary outcome of death, MI, or refractory ischemia, with a significant between-group difference (P = 0.002). Trial underpowered- Subgroup analysis (high-risk subset) of this overall negative trial was not robust a