Saleh Moussa, Ambrose John A
Division of Cardiology, Department of Internal Medicine, University of California San Francisco-Fresno, 2335 E. Kashian Lane, Suite 460, Fresno, CA 97301, USA.
F1000Res. 2018 Sep 3;7. doi: 10.12688/f1000research.15096.1. eCollection 2018.
Over the last 40 years, our understanding of the pathogenesis of myocardial infarction has evolved and allowed new treatment strategies that have greatly improved survival. Over the years, there has been a radical shift in therapy from passive healing of the infarction through weeks of bed rest to early discharge usually within 2 to 3 days as a result of immediate reperfusion strategies and other guideline-directed medical therapies. Nevertheless, challenges remain. Patients who develop cardiogenic shock still face a high 30-day mortality of at least 40%. Perhaps even more important is how do we identify and prevent patients from developing myocardial infarction in the first place? This article discusses these milestones of therapy and considers important issues for progress in the future.
在过去的40年里，我们对心肌梗死发病机制的理解不断发展，并催生了新的治疗策略，这些策略极大地提高了生存率。多年来，治疗方式发生了根本性的转变，从通过数周卧床休息让梗死被动愈合，转变为由于立即再灌注策略和其他指南指导的药物治疗，通常在2至3天内即可早期出院。然而，挑战依然存在。发生心源性休克的患者30天死亡率仍然很高，至少为40%。或许更重要的是，我们如何首先识别并预防患者发生心肌梗死？本文将讨论这些治疗的里程碑，并思考未来取得进展的重要问题。
