Sweeney J P, Schwartz G G
Cardiology Section, Department of Veterans Affairs (VA) Medical Center, San Francisco, CA 94121, USA.
West J Med. 1996 Mar;164(3):238-48.
Mortality from acute myocardial infarction has declined in recent years, largely due to the widespread application of new pharmacologic and mechanical interventions that have been tested in large, prospective, randomized clinical trials. For practicing generalists, we review the key data from such trials that have shaped the current management of patients with acute myocardial infarction. We discuss the roles of thrombolytic therapy, coronary angioplasty, nitrates, beta- and calcium channel blockers, angiotensin-converting-enzyme inhibitors, magnesium, and antiarrhythmic and antithrombotic agents. In addition, we highlight critical unanswered questions in the management of this disorder.
近年来，急性心肌梗死的死亡率有所下降，这主要归功于新的药物和机械干预措施的广泛应用，这些措施已在大型、前瞻性、随机临床试验中得到验证。对于普通执业医生，我们回顾了这些试验的关键数据，这些数据塑造了目前急性心肌梗死患者的治疗方式。我们讨论了溶栓治疗、冠状动脉血管成形术、硝酸盐、β受体阻滞剂和钙通道阻滞剂、血管紧张素转换酶抑制剂、镁以及抗心律失常和抗血栓药物的作用。此外，我们还强调了该疾病治疗中尚未解决的关键问题。
