Ernst N, de Boer M-J, Zijlstra F, Suryapranata H, Dambrink J-H E, Hoorntje J C A, van 't Hof A W J
Neth Heart J. 2006 Feb;14(2):55-61.
Primary coronary angioplasty has been shown to be an effective reperfusion therapy for patients with acute myocardial infarction, not only for those who present to PTCA centres but also for patients who present to hospitals without angioplasty facilities. With the increasing use of primary angioplasty more patients will be transferred to a (tertiary) PTCA centre. An increase in treatment delay is associated with a worse clinical outcome. The importance of an open infarct-related vessel at acute angiography is becoming clear. Pharmacological pretreatment of patients during transportation to a PTCA centre with the aim to open the infarct-related vessel in advance might be beneficial. Glycoprotein IIb/IIIa receptor blockers seem to be the agents of choice for facilitated PTCA. The safety and (cost) effectiveness of this pretreatment of patients transported to undergo primary angioplasty remain to be evaluated.
直接冠状动脉血管成形术已被证明是治疗急性心肌梗死患者的一种有效再灌注疗法，不仅适用于那些前往经皮冠状动脉腔内血管成形术（PTCA）中心的患者，也适用于那些前往没有血管成形术设备的医院就诊的患者。随着直接血管成形术的使用增加，更多患者将被转至（三级）PTCA中心。治疗延迟增加与较差的临床结果相关。急性血管造影时开通梗死相关血管的重要性正变得清晰。在将患者转运至PTCA中心的过程中，对患者进行药物预处理以期提前开通梗死相关血管可能有益。糖蛋白IIb/IIIa受体阻滞剂似乎是易化PTCA的首选药物。对转运接受直接血管成形术的患者进行这种预处理的安全性和（成本）效益仍有待评估。
