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[急性冠状动脉综合征:诊断与治疗]

[Acute coronary syndrome: diagnosis and treatment].

作者信息

Stehli Julia, Stähli Barbara E

机构信息

Universitätsspital Zürich, Klinik für Kardiologie / Universitäres Herzzentrum, Zürich, Schweiz.

出版信息

Praxis (Bern 1994). 2024 Jan;113(1):3-7.

Abstract

In Switzerland, about 20 000 people experience an acute coronary syndrome (ACS) event each year. Acute coronary syndromes comprise ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. The diagnosis is made based on the clinical presentation, a rise in cardiac biomarkers, and ischemic ECG changes. In patients with acute STEMI, urgent coronary angiography with primary percutaneous coronary intervention (PCI) to open the occluded artery is indicated. In patients with NSTEMI and unstable angina, the timing of coronary angiography and PCI is based on the clinical presentation and on a comprehensive and individualized risk stratification. Optimal secondary prevention and aggressive cardiovascular risk factor control are important following the acute event. Keywords.

摘要

在瑞士,每年约有2万人经历急性冠状动脉综合征(ACS)事件。急性冠状动脉综合征包括ST段抬高型心肌梗死(STEMI)、非ST段抬高型心肌梗死(NSTEMI)和不稳定型心绞痛。诊断基于临床表现、心脏生物标志物升高以及缺血性心电图改变。对于急性STEMI患者,建议进行紧急冠状动脉造影并采用直接经皮冠状动脉介入治疗(PCI)以开通闭塞动脉。对于NSTEMI和不稳定型心绞痛患者,冠状动脉造影和PCI的时机基于临床表现以及全面且个体化的风险分层。急性事件后,最佳的二级预防和积极控制心血管危险因素非常重要。关键词。

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