Acute ST-Segment Elevation Myocardial Infarction

摘要: This chapter about fibrinolytic, antiplatelet, and antithrombin treatment for acute ST-segment elevation (STE) myocardial infarction (MI) is part of the American College Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong indicate that benefits do, or do not, outweigh risks, burden, costs. 2 suggests individual patient values may lead to different choices (for a full understanding grading see by Guyatt et al, CHEST 2008; 133[suppl]:123S–131S). Among key in this following: patients with ischemic symptoms characteristic MI ≤ 12 h duration persistent STE, we recommend all undergo rapid evaluation reperfusion (primary percutaneous coronary intervention [PCI] fibrinolytic) therapy have strategy implemented promptly after contact health-care system (Grade 1A). For administration streptokinase, anistreplase, alteplase, reteplase, tenecteplase over no fibrinolytic (all symptom 6 h, alteplase streptokinase (both We aspirin followed indefinite 1A); also clopidogrel addition up 28 days In other antiplatelet therapies, use (eg, unfractionated heparin (UFH), enoxaparin, fondaparinux) 1A), including those receiving fibrinolysis (and regardless which lytic agent administered), primary PCI, not therapy.