Vecchio Sabine, Varani Elisabetta, Chechi Tania, Balducelli Marco, Vecchi Giuseppe, Aquilina Matteo, Ricci Lucchi Giulia, Dal Monte Alessandro, Margheri Massimo
Sabine Vecchio, Elisabetta Varani, Marco Balducelli, Giuseppe Vecchi, Matteo Aquilina, Giulia Ricci Lucchi, Alessandro Dal Monte, Massimo Margheri, Division of Cardiology, Cardiac Catheterization Laboratory, Santa Maria Delle Croci Hospital, 48121 Ravenna, Italy.
World J Cardiol. 2014 Jun 26;6(6):381-92. doi: 10.4330/wjc.v6.i6.381.
Acute ST-elevation myocardial infarction (STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator, which is mostly proportional to their size and composition. Particularly, intracoronary thrombi impair both epicardial blood flow and myocardial perfusion, by occluding major coronary arteries and causing distal embolization, respectively. Thus, although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting, the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients, by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used in the setting of STEMI to manage thrombotic lesions.
急性ST段抬高型心肌梗死（STEMI）通常由冠状动脉粥样硬化斑块破裂并伴有血栓形成所致。冠状动脉血栓的检测是一个不良的预后指标，其大多与血栓的大小和成分成正比。特别是，冠状动脉内血栓分别通过阻塞主要冠状动脉和导致远端栓塞，损害心外膜血流和心肌灌注。因此，尽管在STEMI情况下，直接经皮冠状动脉介入治疗是首选的治疗策略，但联合使用辅助抗血栓药物和/或经皮血栓切除术对于优化STEMI患者的治疗至关重要，因为这可以改善血管造影和临床结果。这篇综述文章将聚焦于冠状动脉内血栓的预后意义以及目前在STEMI情况下用于处理血栓性病变的抗血栓药物治疗和介入策略。
