CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018.
CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018.
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DOI：
10.1007/s12928-018-0516-y
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发表时间：
2018-04
影响因子：
3.2
通讯作者：
Task Force on Primary Percutaneous Coronary Intervention (PCI) of the Japanese Cardiovascular Interventional Therapeutics (CVIT)
中科院分区：
文献类型：
--
作者：
Ozaki Y;Katagiri Y;Onuma Y;Amano T;Muramatsu T;Kozuma K;Otsuji S;Ueno T;Shiode N;Kawai K;Tanaka N;Ueda K;Akasaka T;Hanaoka KI;Uemura S;Oda H;Katahira Y;Kadota K;Kyo E;Sato K;Sato T;Shite J;Nakao K;Nishino M;Hikichi Y;Honye J;Matsubara T;Mizuno S;Muramatsu T;Inohara T;Kohsaka S;Michishita I;Yokoi H;Serruys PW;Ikari Y;Nakamura M;Task Force on Primary Percutaneous Coronary Intervention (PCI) of the Japanese Cardiovascular Interventional Therapeutics (CVIT)
虽然直接经皮冠状动脉介入治疗(PCI)显著提高了ST段抬高心肌梗死患者的死亡率，即使在心源性休克的情况下也是如此，但直接经皮冠状动脉介入治疗是大多数日本机构的标准护理。虽然在日本有大量可用的机构提供初级经皮冠状动脉介入治疗，但没有明确的指南侧重于标准化护理的程序方面。虽然欧洲心脏病学会最近公布了最新的急性心肌梗死治疗指南，但仍指出了以下重大变化：(1)径向通路和药物洗脱支架优于裸金属支架被推荐为I级适应症，(2)出院前(无论是立即还是分期)完全血运重建现在被认为是IIa级建议。虽然在最近和以前的指南中一直推荐初级PCI，但该设备落后于欧洲，日本频繁使用冠状动脉成像方式，以及可用药物治疗或机械支持的差异，可能会阻碍欧洲指南直接应用于日本人群。日本心血管介入治疗协会(CVIT)的首次经皮冠状动脉介入治疗工作组现已提出了一份关于急性心肌梗死治疗的专家共识文件，重点是直接经皮冠状动脉介入治疗的程序方面。
While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI.