美国出台新的不稳定性心绞痛治疗指导方案
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2000年9月7日
New guidelines announced for management of unstable angina, NSTEMI
WESTPORT, Sep 05 (Reuters Health) - The American College of Cardiology (ACC) and the American Heart Association (AHA) have announced new guidelines for the treatment of patients with unstable angina or non-ST-segment-elevation myocardial infarction (NSTEMI).
The new guidelines reenforce clinical history and 12-lead electrocardiography as the basis for early diagnosis. In addition, they recommend testing for cardiac biochemical markers, particularly troponin I and troponin T.
"Unstable angina and NSTEMI are considered to be closely related conditions whose pathogenesis and clinical presentations are similar but of differing severity," the document states. "Once it has been established that no biochemical marker of myocardial necrosis has been released, the patient with an acute coronary syndrome may be considered to have experienced unstable angina, whereas the diagnosis of NSTEMI is established if a marker of myocardial injury has been released."
The ACC and AHA recommend a triple pharmacological approach to treatment. The guidelines recommend aspirin, or clopidogrel or ticlopidine for patients who cannot tolerate aspirin, plus a glycoprotein IIb/IIIa inhibitor and heparin or low-molecular-weight heparin.
For high-risk patients who continue to show signs of fluid overload, arrhythmias, or other severe signs, the guidelines call for a percutaneous coronary revascularization procedure. "The majority of current PCIs involve balloon dilatation and coronary stenting."
The complete guidelines are published in the September issue of the Journal of the American College of Cardiology, and an executive summary is available in the September 5th issue of Circulation: Journal of the American Heart Association.
J Am Coll Cardiol 2000;36:970-1062., 百拇医药
WESTPORT, Sep 05 (Reuters Health) - The American College of Cardiology (ACC) and the American Heart Association (AHA) have announced new guidelines for the treatment of patients with unstable angina or non-ST-segment-elevation myocardial infarction (NSTEMI).
The new guidelines reenforce clinical history and 12-lead electrocardiography as the basis for early diagnosis. In addition, they recommend testing for cardiac biochemical markers, particularly troponin I and troponin T.
"Unstable angina and NSTEMI are considered to be closely related conditions whose pathogenesis and clinical presentations are similar but of differing severity," the document states. "Once it has been established that no biochemical marker of myocardial necrosis has been released, the patient with an acute coronary syndrome may be considered to have experienced unstable angina, whereas the diagnosis of NSTEMI is established if a marker of myocardial injury has been released."
The ACC and AHA recommend a triple pharmacological approach to treatment. The guidelines recommend aspirin, or clopidogrel or ticlopidine for patients who cannot tolerate aspirin, plus a glycoprotein IIb/IIIa inhibitor and heparin or low-molecular-weight heparin.
For high-risk patients who continue to show signs of fluid overload, arrhythmias, or other severe signs, the guidelines call for a percutaneous coronary revascularization procedure. "The majority of current PCIs involve balloon dilatation and coronary stenting."
The complete guidelines are published in the September issue of the Journal of the American College of Cardiology, and an executive summary is available in the September 5th issue of Circulation: Journal of the American Heart Association.
J Am Coll Cardiol 2000;36:970-1062., 百拇医药