Early invasive strategy should be performed within 72 hours in high-risk patients with non-ST-elevation myocardial infarction.

Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-23 DOI:10.1136/ebmed-2017-110848
Carlos Collet, Patrick W Serruys
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引用次数: 1

Abstract

Commentary on : Jobs A, Mehta SR, Montalescot G, et al . Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials. Lancet 2017;390:737–46. The mainstay of treatment for patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS) is medical therapy, early coronary angiography and revascularisation. A routine invasive strategy has been shown to reduce all-cause death and myocardial infarction  compared with a conservative approach at 5 years.1 Therefore, an early invasive strategy with intent to perform revascularisation is advocated in the 2014 American and European guidelines with a class I recommendation.2 3 While immediate angiography is recommended for extremely high-risk patients (eg, haemodynamic or electrical instability, persistent angina, heart failure or worsening mitral regurgitation), the optimal timing for an invasive approach in patients …
非st段抬高型心肌梗死高危患者应在72小时内行早期有创策略。
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