Knudtson Merril L, Norris Colleen M, Galbraith P Diane, Hubacek Jaro, Ghali William A
Department of Cardiovascular Sciences, University of Calgary, Alberta, Canada.
Can J Cardiol. 2009 Jun;25 Suppl A(Suppl A):29A-36A. doi: 10.1016/s0828-282x(09)71051-7.
At least implicitly, most clinical decisions represent an integration of disease and treatment-based risk assessments. Often, as is the case with acute coronary syndrome (ACS), these decisions need to be made quickly at a time when data elements are limited, and published risk models are very useful in clarifying time-dependent determinants of risk. The present review emphasizes the value of explicit risk assessment and reinforces the fact that patients at highest risk are often those most likely to benefit from newer and more invasive therapies. Suggested ways to incorporate published ACS risk models into clinical practice are included. In addition, the need to adopt a longer-term view of risk in ACS patients is stressed, with particular regard to the important role of heart failure prediction and treatment.
至少在隐性层面上，大多数临床决策都代表着基于疾病和治疗的风险评估的整合。通常，就急性冠状动脉综合征（ACS）而言，这些决策需要在数据元素有限的情况下迅速做出，而已发表的风险模型在明确风险的时间依赖性决定因素方面非常有用。本综述强调了明确风险评估的价值，并强化了这样一个事实，即风险最高的患者往往是那些最有可能从更新的、更具侵入性的治疗中获益的患者。文中还包括了将已发表的ACS风险模型纳入临床实践的建议方法。此外，强调了对ACS患者的风险采取更长期观点的必要性，尤其关注心力衰竭预测和治疗的重要作用。
