2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction - A report of the American college of cardiology/American heart association task force on practice guidelines
2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction - A report of the American college of cardiology/American heart association task force on practice guidelines
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DOI：
10.1161/circulationaha.107.188209
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发表时间：
2008-01-15
期刊：
影响因子：
37.8
通讯作者：
Smith, Sidney C., Jr.
中科院分区：
文献类型：
--
作者：
Antman, Elliott M.;Hand, Mary;Smith, Sidney C., Jr.
在2005年和2006年ACC、AHA和欧洲心脏病学会的年度科学会议上提交的最新临床试验以及选定的其他数据，由常设指南编写委员会与上级工作组沿着和其他专家进行审查，以确定这些试验和其他可能影响指南建议的关键数据。基于上述标准/考虑，认为最近的试验数据和其他临床信息足够重要，足以促使对2004年ACC/AHA ST段抬高心肌梗死患者管理指南进行重点更新[见Chen ZM等人3; Chen ZM等人4; ASSENT-4 PCI 5; Antman EM等人6; Yusuf S等人7; Bhatt DL等8; Sabatine MS等9;班尼特JS等10; Smith SC Jr等11; OAT 12、13和TOSCA 14]。在考虑这一重点更新的新数据时，编写小组面临的任务是权衡来自北美以外招募大量受试者的研究的证据。尽管注意到实践模式和数据收集的严格性以及受试者的遗传构成可能会影响观察到的治疗效果的大小，但撰写组认为这些数据与制定北美ST段抬高型心肌梗死（STEMI）的管理建议有关。做出这一决定的原因包括：1）代表了广泛的管理策略，包括接受某种形式再灌注治疗的相当大比例的受试者，2）经证实有效的伴随治疗（例如，阿司匹林、β受体阻滞剂、肾素-血管紧张素醛固酮系统抑制剂和他汀类药物）用于大多数患者，和3）认为仅在北美研究中心招募数万名STEMI患者以满足当代临床试验的估计样本量是不切实际的期望。
Late-breaking clinical trials presented at the 2005 and 2006 annual scientific meetings of the ACC, AHA, and European Society of Cardiology, as well as selected other data, were reviewed by the standing guideline writing committee along with the parent Task Force and other experts to identify those trials and other key data that might impact guidelines recommendations. On the basis of the criteria/considerations noted above, recent trial data and other clinical information were considered important enough to prompt a focused update of the 2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction [see Chen ZM et al. 3; Chen ZM et al. 4; ASSENT-4 PCI 5; Antman EM et al. 6; Yusuf S et al. 7; Bhatt DL et al. 8; Sabatine MS et al. 9; Bennett JS et al. 10; Smith SC Jr et al. 11; OAT 12, 13 and TOSCA 14].When considering the new data for this focused update, the writing group faced the task of weighing evidence from studies enrolling large numbers of subjects outside North America. Although noting that practice patterns and the rigor applied to data collection, as well as the genetic makeup of subjects, might influence the observed magnitude of a treatment effect, the writing group believed the data were relevant to formulation of recommendations for management of ST-elevation myocardial infarction (STEMI) in North America. The reasons for this decision include that 1) a broad array of management strategies was represented, including substantial proportions of subjects who received some form of reperfusion therapy, 2) concomitant treatments with proven efficacy (eg, aspirin, beta blockers, inhibitors of the renin-angiotensinaldosterone system, and statins) were used in the majority of patients, and 3) it was considered an impractical expectation that the tens of thousands of patients with STEMI needed to meet the estimated sample size for contemporary clinical trials be enrolled exclusively at North American sites.