STEMI合并多支血管病变的血运重建策略被引量：1

Revascularization strategy for STEMI patients with multivessel disease

下载PDF

导出

摘要 ST段抬高型心肌梗死(STEMI)合并多支血管病变较为常见,且往往提示预后不良。在成功开通梗死相关血管后,直接PCI(PPCI)时是否应同期处理非梗死相关血管一直存在争议。近年来,越来越多的证据提示,与仅处理梗死相关血管相比,对非梗死相关血管同期进行血运重建的患者预后较好。然而,有关非梗死相关血管的选择和处理时机仍然颇具争议。本文回顾了最新的临床证据,旨在为合并多支血管病变的STEMI患者的诊治提供思路。 ST-segment elevation myocardial infarction(STEMI)in patients with multivessel disease is a common situation,and suggests poor prognosis.After the reperfusion of infarct-related blood vessels in the primary PCI(PPCI),how to deal with the non-infarct related vessel has been a hot issue.In recent years,more and more evidence suggests that compared with treatment of infarct-related vessels only,revascularization of non-infarct related vessels will result in a better prognosis.But the timing and the choice of non-infarct-related vessel revascularization are still controversial.This article reviews the latest clinical evidence to improve the diagnosis and treatment of STEMI patients with multivessel disease.

作者赵冠棋师树田王晓聂绍平 ZHAO Guan-qi;SHI Shu-tian;WANG Xiao;NIE Shao-ping(Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)

机构地区首都医科大学附属北京安贞医院急诊危重症中心

出处《天津医药》 CAS 2017年第11期1135-1138,共4页 Tianjin Medical Journal

基金北京市医院管理局重点医学专业发展计划(ZYLX201710) 北京市医院管理局科研培育计划(PX2016048) 北京市医院管理局"青苗"计划(QML20160605)

关键词 ST段抬高型心肌梗死直接PCI 多支血管病变非梗死相关血管血运重建 ST-segment elevation myocardial infarction primary PCI multivessel disease non-infarct related vessel revascularization

分类号 R541.4 [医药卫生—心血管疾病]

引文网络
相关文献

参考文献2

1曾秋棠,彭昱东.冠状动脉多支病变ST段抬高型心肌梗死患者直接PCI是否需要完全血运重建[J].临床心血管病杂志,2016,32(5):433-435. 被引量：1
2徐玲霞,陈康寅,李广平.多支血管病变ST段抬高型急性心肌梗死的PCI治疗策略选择[J].山东医药,2015,55(15):99-101. 被引量：6

二级参考文献41

1Gibbons RJ,Holmes DR,Reeder GS,et al.Immediate angioplasty compared with the administration of a thrombolytic agent followed by conservative treatment for myocardial infarction.The Mayo Coronary Care Unit and Catheterization Laboratory Groups[J].N Engl J Med,1993,328(10):685-691.
2Widimsky P,Budesinsky T,Vorac D,et al.Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction.Final results of the randomized national multicentre trial--PRAGUE-2[J].Eur Heart J,2003,24(1):94-104.
3Cannon CP,Weintraub WS,Demopoulos LA,et al.Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban[J].N Engl J Med,2001,344(25):1879-1887.
4Stone GW,Grines CL,Cox DA,et al.Comparison of angioplasty with stenting,with or without abciximab,in acute myocardial infarction[J].N Engl J Med,2002,346(13):957-966.
5Mcpherson JA,Maehara A,Weisz G,et al.Residual plaque burden in patients with acute coronary syndromes after successful percutaneous coronary intervention[J].JACC Cardiovasc Imaging,2012,5(3 Suppl):S76-S85.
6Sorajja P,Gersh BJ,Cox DA,et al.Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction[J].Eur Heart J,2007,28(14):1709-1716.
7Kushner FG,Hand M,Smith SJ,et al.2009 focused updates:ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction(updating the 2004 guideline and 2007focused update)and ACC/AHA/SCAI guidelines on percutaneous coronary intervention(updating the 2005 guideline and 2007 focused update)a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2009,54(23):2205-2241.
8Wijns W,Kolh P,Danchin N,et al.Guidelines on myocardial revascularization[J].Eur Heart J,2010,31(20):2501-2555.
9Politi L,Sgura F,Rossi R,et al.A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction:major adverse cardiac events during long-term follow-up[J].Heart,2010,96(9):662-667.
10Hannan EL,Samadashvili Z,Walford G,et al.Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease[J].JACC Cardiovasc Interv,2010,3(1):22-31.