急性心肌梗死的溶栓和急诊pci英文课件.ppt

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1、,急性心肌梗死的溶栓和急诊PCISTEMI：Thrombolytic Therapy and PCI,Southwest Hospital,何国祥第三军医大学西南医院重庆市介入心脏病学研究所Dept.of Cardiology,Southwest HospitalThe Thrid Military Medical UniversityChongqing Institute of Interventional Cardiology,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for ly

2、sis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infar

3、ction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）

4、,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospit

5、al,STEMI的直接PCI:影响近远期预后的因素,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,Meta-Analysis of 23 Randomized Trial

6、s PCI vs Lysis(n=7739),ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STE

7、MI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myoc

8、ardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment

9、elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary

10、PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends fo

11、r lysis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,So

12、uthwest Hospital,ConclusionsImmediate transfer for PCI did not improve the primary outcome significantly,but reduced the rate of death,reinfarction,or stroke at 12 months in patients with STEMI,treated with thrombolysis and clopidogrel in areas with longtransfer distances.(Norwegian Study on Distric

13、t Treatment of ST-Elevation Myocardial Infarction.J Am Coll Cardiol 2010;55:10210,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Lancet 2004;364:104553,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Southwest Hospital,ConclusionsIn patie

14、nts with STEMI,early post-thrombolysis catheterisation and appropriate intervention is safeand might be preferable to a conservative strategy since it reduces the need for unplanned in-hospitalrevascularisation,and improves 1-year clinical outcome.,Southwest Hospital,Southwest Hospital,Southwest Hos

15、pital,Southwest Hospital,Southwest Hospital,Conclusions Early elective PCI within 48 hours of successfulthrombolytic therapy for AMI appeared safe and more beneficial compared with PCIperformed later.Am J Cardiol 2009;103:13331338,Southwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Ho

16、spital,ConclusionsThe mortality benefit of immediate referral to PCI after pharmacological treatment for STEMIderives from a reduction in the time to reperfusion of patients with failed thrombolysis in need of rescue PCI.In patients with evidence of successful reperfusion,“elective”PCI within 3 days

17、 may be sufficient to reduce the recurrent ischemic events.,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STEMI“D to N”and“D to B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue PCI8.Facilitated PCI,So

18、uthwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Trends for lysis and PCI for STEMI“D to N”and“D to

19、 B”PCI vs FibrinolysisPrimary PCITransfer for Primary PCIImmediate PCI7.Rescue8.Facilitated PCI,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,Southwest Hospital,Lancet 2006;367:56978,Southwest Hospital,Southwest Hospital,Southwest Hospital,Southwest Hospital

20、,Southwest Hospital,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Southwest Hospital,ST-segment elevation myocardial infarction（STEMI）,Fig.1.Organization of ST-segment elevation myocardial infarction patient pathway describing pre-and in-hospital management and reperfusion strategies within 12 h of first medical contact.,ST-segment elevation myocardial infarction（STEMI）,Welcome to new Chongqing!,Thank you!,ST-segment elevation myocardial infarction（STEMI）,