Ørn S, Dickstein K
Cardiology Division, Central Hospital, Rogaland, N-4003 Stavanger, Norway.
Expert Opin Pharmacother. 2000 Sep;1(6):1105-16. doi: 10.1517/14656566.1.6.1105.
Modern treatment of acute myocardial infarction (AMI), including thrombolysis and early interventional strategies, has reduced mortality rates but increased the number of patients requiring medical treatment. Post infarction treatment with aspirin, statins, beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has improved morbidity and mortality and is cost-effective. The major successes of secondary prevention have been seen in the prevention of reinfarction, recurrent ischaemia and the development of heart failure. However, in spite of recent advances and increasing knowledge, the mortality rates remain high, partly due to the under use of the established and documented medical strategies. Implementation of the current treatment strategies into general practice remains a challenge. The field is undergoing rapid change due to the increasing use of early invasive strategies. The primary objective should remain the prevention of underlying aetiology: coronary artery disease (CAD). Secondary prevention following myocardial infarction (MI) will remain a major challenge in clinical practice within the foreseeable future.
急性心肌梗死（AMI）的现代治疗方法，包括溶栓和早期介入策略，已降低了死亡率，但需要治疗的患者数量有所增加。心肌梗死后使用阿司匹林、他汀类药物、β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂进行治疗，已改善了发病率和死亡率，且具有成本效益。二级预防的主要成效体现在预防再梗死、复发性缺血以及心力衰竭的发生方面。然而，尽管最近取得了进展且知识不断增加，但死亡率仍然很高，部分原因是既定的、有文献记载的医疗策略使用不足。将当前治疗策略应用于常规临床实践仍然是一项挑战。由于早期侵入性策略的使用增加，该领域正在迅速变化。主要目标仍应是预防潜在病因：冠状动脉疾病（CAD）。在可预见的未来，心肌梗死（MI）后的二级预防仍将是临床实践中的一项重大挑战。
