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2019冠状病毒病大流行期间急性冠状动脉综合征的管理：与指南的偏差及对患者和医护人员的实际考量

Management of Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic: Deviations from Guidelines and Pragmatic Considerations for Patients and Healthcare Workers.

作者信息

Seligman Henry, Sen Sayan, Nijjer Sukhjinder, Al-Lamee Rasha, Clifford Piers, Sethi Amarjit, Hadjiloizou Nearchos, Kaprielian Raffi, Ramrakha Punit, Bellamy Michael, Khan Masood A, Kooner Jaspal, Foale Rodney A, Mikhail Ghada, Baker Christopher S, Mayet Jamil, Malik Iqbal, Khamis Ramzi, Francis Darrel, Petraco Ricardo

机构信息

Imperial College Healthcare NHS Trust London, UK.

National Heart and Lung Institute Imperial College London, UK.

出版信息

Interv Cardiol. 2020 Nov 24;15:e16. doi: 10.15420/icr.2020.21. eCollection 2020 Apr.

DOI:10.15420/icr.2020.21
PMID:33318752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7726851/
Abstract

Coronavirus disease 2019 (COVID-19) is forcing cardiology departments to rapidly adapt existing clinical guidelines to a new reality and this is especially the case for acute coronary syndrome pathways. In this focused review, the authors discuss how COVID-19 is affecting acute cardiology care and propose pragmatic guideline modifications for the diagnosis and management of acute coronary syndrome patients, particularly around the appropriateness of invasive strategies as well as length of hospital stay. The authors also discuss the use of personal protective equipment for healthcare workers in cardiology. Based on shared global experiences and growing peer-reviewed literature, it is possible to put in place modified acute coronary syndrome treatment pathways to offer safe pragmatic decisions to patients and staff.

摘要

2019冠状病毒病（COVID-19）正迫使心脏病学部门迅速将现有的临床指南应用于新的实际情况，急性冠状动脉综合征诊疗路径尤其如此。在这篇重点综述中，作者讨论了COVID-19如何影响急性心脏病治疗，并针对急性冠状动脉综合征患者的诊断和管理提出了务实的指南修订建议，特别是关于侵入性策略的合理性以及住院时间。作者还讨论了心脏病学医护人员个人防护装备的使用。基于全球共同经验和不断增加的同行评审文献，有可能制定经修订的急性冠状动脉综合征治疗路径，为患者和医护人员提供安全务实的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/6f11258d6c29/icr-15-e16-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/0ef4a848008d/icr-15-e16-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/c19876c34d33/icr-15-e16-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/6f11258d6c29/icr-15-e16-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/0ef4a848008d/icr-15-e16-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/c19876c34d33/icr-15-e16-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f0/7726851/6f11258d6c29/icr-15-e16-g003.jpg

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本文引用的文献

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Heart. 2020 Dec;106(23):1805-1811. doi: 10.1136/heartjnl-2020-317650. Epub 2020 Aug 31.
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An In-hospital Pathway for Acute Coronary Syndrome Patients During the COVID-19 Outbreak: Initial Experience Under Real-World Suboptimal Conditions.在 COVID-19 大流行期间急性冠状动脉综合征患者的院内通路：在现实世界中条件欠佳情况下的初步经验。
Can J Cardiol. 2020 Jun;36(6):961-964. doi: 10.1016/j.cjca.2020.04.011. Epub 2020 Apr 17.
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Impact of coronavirus disease 2019 (COVID-19) outbreak on outcome of myocardial infarction in Hong Kong, China.
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Catheter Cardiovasc Interv. 2021 Feb 1;97(2):E194-E197. doi: 10.1002/ccd.28943. Epub 2020 May 5.
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Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy.意大利北部新冠疫情期间急性冠状动脉综合征住院率降低
N Engl J Med. 2020 Jul 2;383(1):88-89. doi: 10.1056/NEJMc2009166. Epub 2020 Apr 28.
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