Nakashima Takahiro, Tahara Yoshio
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, 565-8565 Japan.
J Intensive Care. 2018 Mar 15;6:20. doi: 10.1186/s40560-018-0285-9. eCollection 2018.
Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. Appropriate management of ACS will lead to a lower incidence of cardiac arrest. Percutaneous coronary intervention (PCI) is the first-line treatment for patients with ACS. PCI techniques have become established. Thus, the establishment of a system of health care in the prehospital and emergency department settings is needed to reduce mortality in patients with ACS. In this review, evidence on how to achieve earlier diagnosis, therapeutic intervention, and decision to reperfuse with a focus on the prehospital and emergency department settings is systematically summarized. The purpose of this review is to generate current, evidence-based consensus on scientific and treatment recommendations for health care providers who are the initial points of contact for patients with signs and symptoms suggestive of ACS.
急性冠状动脉综合征(ACS)仍然是全球主要的死亡原因之一。对ACS进行适当管理将降低心脏骤停的发生率。经皮冠状动脉介入治疗(PCI)是ACS患者的一线治疗方法。PCI技术已经确立。因此,需要建立院前和急诊科环境中的医疗保健系统,以降低ACS患者的死亡率。在本综述中,系统地总结了关于如何实现早期诊断、治疗干预以及以院前和急诊科环境为重点的再灌注决策的证据。本综述的目的是为那些作为出现提示ACS体征和症状患者的初始接触点的医疗保健提供者,就科学和治疗建议形成基于当前证据的共识。