Jobs A, Eitel I, Desch S
Medizinische Klinik II, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Herz. 2014 Sep;39(6):677-84. doi: 10.1007/s00059-014-4126-x.
The optimal timing of invasive diagnosis and therapy in patients with non-ST-elevation myocardial infarction (NSTEMI) is still a matter of debate. The European Society of Cardiology recommends invasive diagnosis evaluation and revascularization for practically all patients with NSTEMI within 72 h. High risk and very high risk patients should be evaluated invasively with coronary angiography within 24 h or 2 h, respectively. The risk of the individual patient should be stratified by means of the Global Registry of Acute Coronary Events (GRACE) risk score. The recommendations and guidelines are based on the results of several randomized, controlled trials and are in accordance with other retrospective studies. However, observational studies indicate that in real life many high risk patients are not evaluated invasively by coronary angiography as timely as recommended.
非ST段抬高型心肌梗死（NSTEMI）患者进行侵入性诊断和治疗的最佳时机仍存在争议。欧洲心脏病学会建议，几乎所有NSTEMI患者应在72小时内进行侵入性诊断评估和血运重建。高危和极高危患者应分别在24小时或2小时内通过冠状动脉造影进行侵入性评估。应通过全球急性冠状动脉事件注册研究（GRACE）风险评分对个体患者的风险进行分层。这些建议和指南基于多项随机对照试验的结果，并与其他回顾性研究一致。然而，观察性研究表明，在现实生活中，许多高危患者并未按照建议及时通过冠状动脉造影进行侵入性评估。
