Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Division of Cardiology, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; Division of Cardiology, Department of Internal Medicine, China Medical University College of Medicine and Hospital, Taichung, Taiwan.
J Formos Med Assoc. 2018 Sep;117(9):766-790. doi: 10.1016/j.jfma.2018.06.002. Epub 2018 Jul 13.
In Taiwan, the incidence of non-ST segment elevation acute coronary syndrome (NSTE-ACS) continues to increase in recent years. The purpose of this guideline is to help health care professionals in Taiwan to use adequate tests and treatments for management of NSTE-ACS. For rapid diagnosis, in addition to history and physical examination, 0/3 h rapid diagnosis protocol with high sensitivity cardiac troponin assay is recommended in this guideline. Dual antiplatelet and anticoagulation therapies are important parts in the initial treatment. Risk stratification should be performed to identify high risk patients for early coronary angiography. Through evaluation of the coronary anatomy and other clinical factors, the decision for coronary revascularization, either by percutaneous coronary intervention or coronary artery bypass grafting, should be decided by the heart team. The duration of dual antiplatelet therapy should be given for at least 12 months after discharge. Other secondary preventive medications are also recommended for long term use.
在台湾,近年来非 ST 段抬高型急性冠状动脉综合征(NSTE-ACS)的发病率持续上升。本指南的目的是帮助台湾的医疗保健专业人员对 NSTE-ACS 进行适当的检查和治疗。为了快速诊断,除了病史和体格检查外,本指南还建议使用高敏肌钙蛋白检测的 0/3 h 快速诊断方案。双联抗血小板和抗凝治疗是初始治疗的重要组成部分。应进行风险分层,以确定需要早期进行冠状动脉造影的高危患者。通过评估冠状动脉解剖结构和其他临床因素,应由心脏团队决定进行经皮冠状动脉介入治疗或冠状动脉旁路移植术的血运重建决策。双联抗血小板治疗的持续时间应在出院后至少 12 个月。还建议长期使用其他二级预防药物。