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2024 年 CVIT 专家共识文件:急性冠状动脉综合征(ACS)的直接经皮冠状动脉介入治疗(PCI)

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2024.

机构信息

Department of Cardiology, Fujita Health University Okazaki Medical Center, Fujita Health University School of Medicine, 1-98 Dengaku, Kutsukake, Toyoake, Aichi, 470-1192, Japan.

Department of Cardiology, University of Galway, Galway, Ireland.

出版信息

Cardiovasc Interv Ther. 2024 Oct;39(4):335-375. doi: 10.1007/s12928-024-01036-y. Epub 2024 Sep 20.

Abstract

Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022. Recently, the European Society of Cardiology (ESC) published the guidelines for the management of acute coronary syndrome in 2023. Major new updates in the 2023 ESC guideline include: (1) intravascular imaging should be considered to guide PCI (Class IIa); (2) timing of complete revascularization; (3) antiplatelet therapy in patient with high-bleeding risk. Reflecting rapid advances in the field, the Task Force on Primary PCI of the CVIT group has now proposed an updated expert consensus document for the management of ACS focusing on procedural aspects of primary PCI in 2024 version.

摘要

直接经皮冠状动脉介入治疗(PCI)显著降低了 ST 段抬高型心肌梗死(STEMI)患者的死亡率,即使在心原性休克患者中也是如此,目前已成为日本大多数医疗机构的标准治疗方法。日本心血管介入治疗学会(CVIT)直接 PCI 工作组于 2018 年提出了一份急性心肌梗死(AMI)管理的专家共识文件,重点关注直接 PCI 的操作方面,并于 2022 年进行了更新。最近,欧洲心脏病学会(ESC)在 2023 年发布了急性冠状动脉综合征管理指南。2023 ESC 指南的主要更新包括:(1)应考虑血管内影像学来指导 PCI(IIa 类);(2)完全血运重建的时机;(3)高出血风险患者的抗血小板治疗。为反映该领域的快速发展,CVIT 直接 PCI 工作组现已提出了 2024 年版的急性冠脉综合征管理更新版专家共识文件,重点关注直接 PCI 的操作方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e2/11436458/d4084800ea86/12928_2024_1036_Fig1_HTML.jpg

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