【新整理】非st段抬高急性冠脈綜合征-全文預(yù)覽
【正文】 MI,Hospital Discharges for ACS NonSTE ACS vs STEMI,NSTE ACS,1.4 Million Discharges/Yr,321,000 Discharge/Yr,NSTE ACS : Key Themes,NSTE ACS: a high risk population ? patient risk ? ? benefit from treatment with medications, an invasive strategy Interaction between invasive strategy and pharmacologic tx Antithrombotics cornerstone of treatment Anticoagulants: heparin, LMWH, direct thrombin inhibitors Antiplatelet agents: aspirin, IIb/IIIa, ADP inhibitors,Baseline Characteristics NSTE ACS Patients: Recent RCTs and Large Registry,Q2 2003 PURSUIT CURE GUSTOIV ACS CRUSADE Characteristic (n = 9,461) (n = 12,562) (n = 7,800) (n = 5,426) Mean age 177。 12 65 177。 NEJM 2001。335:13429,360,240,120,0,20,18,16,14,12,10,8,6,4,2,0,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Cumulative probability of death,84 ml/min,5166 ml/min,51 ml/min,P0.001, log rank,%,6684 ml/min,Aviles RJ et al NEJM 2003,Creatinine Clearance and Mortality GUSTO 4,Days,360,240,120,0,20,18,16,14,12,10,8,6,4,2,0,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Probability of death, %,1869 ng/L,237669 ng/L, 237 ng/L,P0.001, log rank,6691869 ng/L,James S et al Circulation 2003,NTpro BNP GUSTO 4,Days,Invasive vs. Conservative Strategy for ACS Death or (re)MI,Trial N PCI Cons RITA 3 1810 7.6 8.3 VINO 131 6.3 22.4 TACTICS 2220 7.3 9.5 TRUCS 148 7.6 16.7 FRISC II 2451 10.4 14.1 MATE 201 9.9 6.7 VANQUISH 920 24.0 12.2 Overall 7876,Fox, Lancet 360:
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