中国全科医学 ›› 2019, Vol. 22 ›› Issue (8): 888-900.DOI: 10.12114/j.issn.1007-9572.2019.00.029
所属专题: 指南/共识最新文章合集; 心血管最新文章合集
梁峰1,胡大一2,方全3,沈珠军3*
出版日期:
2019-03-15
发布日期:
2019-03-15
基金资助:
LIANG Feng1,HU Dayi2,FANG Quan3,SHEN Zhujun3*
Published:
2019-03-15
Online:
2019-03-15
摘要: ST段抬高型心肌梗死(STEMI)患者急性期的关键治疗是快速再灌注,成功再灌注后所有患者处于心血管事件再发极高危状态,需要依据国内外最新进展推荐进行二级预防治疗和风险因素控制。STEMI患者的长期管理治疗包括:心肌缺血的无创性评价,左心室功能和心源性猝死评价,戒烟,以运动为基础的心脏康复,饮食和体质量控制,血压控制,血糖管理,降脂治疗,长期抗栓治疗,β-受体阻滞剂,血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB),盐皮质激素受体拮抗剂(MRA),改善循证治疗依从性,以及促进治疗协调性的医疗保健体系。
[1]IBANEZ B,JAMES S,AGEWALL S,et al.2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J].Eur Heart J,2018,39(2):119-177.DOI:10.1093/eurheartj/ehx393. [2]American College of Emergency Physicians,Society for Cardiovascular Angiography and Interventions.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2013,61(4):e78-140.DOI:10.1016/j.jacc.2012.11.019. [3]PIEPOLI M F,HOES A W,AGEWALL S,et al.2016 European guidelines on cardiovascular disease prevention in clinical practice:the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice(constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation(EACPR)[J].Eur Heart J,2016,37(29):2315-2381.DOI:10.1093/eurheartj/ehw106. [4]WIJEYSUNDERA H C,VIJAYARAGHAVAN R,NALLAMOTHU B K,et al.Rescue angioplasty or repeat fibrinolysis after failed fibrinolytic therapy for ST-segment myocardial infarction:a meta-analysis of randomized trials[J].J Am Coll Cardiol,2007,49(4):422-430.DOI:10.1016/j.jacc.2006.09.033. [5]FOX K A,DABBOUS O H,GOLDBERG R J,et al.Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome:prospective multinational observational study (GRACE)[J].BMJ,2006,333(7578):1091.DOI:10.1136/bmj.38985.646481.55. [6]FOX K A,FITZGERALD G,PUYMIRAT E,et al.Should patients with acute coronary disease be stratified for management according to their risk?Derivation,external validation and outcomes using the updated GRACE risk score[J].BMJ Open,2014,4(2):e004425.DOI:10.1136/bmjopen-2013-004425. [7]SMITH S C Jr,BENJAMIN E J,BONOW R O,et al.AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease:2011 update:a guideline from the American Heart Association and American College of Cardiology Foundation[J].J Am Coll Cardiol,2011,58(23):2432-2446.DOI:10.1016/j.jacc.2011.10.824. [8]VILLELLA A,MAGGIONI A P,VILLELLA M,et al.Prognostic significance of maximal exercise testing after myocardial infarction treated with thrombolytic agents:the GISSI-2 data-base.Gruppo Italiano per lo Studio della Sopravvivenza Nell'Infarto[J].Lancet,1995,346(8974):523-529. [9]WINDECKER S,KOLH P,ALFONSO F,et al.2014 ESC/EACTS guidelines on myocardial revascularization:the Task Force on Myocardial Revascularization of the European Society of Cardiology(ESC) and the European Association for Cardio-Thoracic Surgery(EACTS).Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions(EAPCI)[J].Eur Heart J,2014,35(37):2541-2619.DOI:10.1093/eurheartj/ehu278. [10]BULLUCK H,WHITE S K,FROHLICH G M,et al.Quantifying the area at risk in reperfused ST-segment-elevation myocardial infarction patients using hybrid cardiac positron emission tomography-magnetic resonance imaging[J].Circ Cardiovasc Imaging,2016,9(3):e003900.DOI:10.1161/CIRCIMAGING.115.003900. [11]STEINBECK G,ANDRESEN D,SEIDL K,et al.Defibrillator implantation early after myocardial infarction[J].N Engl J Med,2009,361(15):1427-1436.DOI:10.1056/NEJMoa0901889. [12]OLGIN J E,PLETCHER M J,VITTINGHOFF E,et al.Wearable cardioverter-defibrillator after myocardial infarction[J].N Engl J Med,2018,379(13):1205-1215.DOI:10.1056/NEJMoa1800781. [13]PRIORI S G,BLOMSTROM-LUNDQVIST C,MAZZANTI A, et al.2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death:the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology(ESC).Endorsed by:association for European Paediatric and Congenital Cardiology(AEPC)[J].Eur Heart J,2015,36(41):2793-2867.DOI:10.1093/eurheartj/ehv316. [14]BARDY G H,LEE K L,MARK D B,et al.Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure[J].N Engl J Med,2005,352(3):225-237. [15]BRIGNOLE M,MOYA A,DE LANGE F J,et al.2018 ESC guidelines for the diagnosis and management of syncope[J].Eur Heart J,2018,39(21):1883-1948.DOI:10.1093/eurheartj/ehy037. [16]COLEMAN E A,MAHONEY E,PARRY C.Assessing the quality of preparation for posthospital care from the patient's perspective:the care transitions measure[J].Med Care,2005,43(3):246-255. [17]WILSON K,GIBSON N,WILLAN A,et al.Effect of smoking cessation on mortality after myocardial infarction:meta-analysis of cohort studies[J].Arch Intern Med,2000,160(7):939-944. [18]CRITCHLEY J A,CAPEWELL S.Mortality risk reduction associated with smoking cessation in patients with coronary heart disease:a systematic review[J].JAMA,2003,290(1):86-97. [19]DAWOOD N,VACCARINO V,REID K J,et al.Predictors of smoking cessation after a myocardial infarction:the role of institutional smoking cessation programs in improving success[J].Arch Intern Med,2008,168(18):1961-1967.DOI:10.1001/archinte.168.18.1961. [20]BALADY G J,WILLIAMS M A,ADES P A,et al.Core components of cardiac rehabilitation/secondary prevention programs:2007 update:a scientific statement from the American Heart Association Exercise,Cardiac Rehabilitation,and Prevention Committee,the Council on Clinical Cardiology;the Councils on Cardiovascular Nursing,Epidemiology and Prevention,and Nutrition,Physical Activity,and Metabolism;and the American Association of Cardiovascular and Pulmonary Rehabilitation[J].Circulation,2007,115(20):2675-2682. [21]SUAYA J A,STASON W B,ADES P A,et al.Cardiac rehabilitation and survival in older coronary patients[J].J Am Coll Cardiol,2009,54(1):25-33. [22]TAYLOR R S,BROWN A,EBRAHIM S,et al.Exercise-based rehabilitation for patients with coronary heart disease:systematic review and meta-analysis of randomized controlled trials[J].Am J Med,2004,116(10):682-692.DOI:10.1016/j.amjmed.2004.01.009. [23]THOMAS R J,KING M,LUI K,et al.AACVPR/ACCF/AHA 2010 update:performance measures on cardiac rehabilitation for referral to cardiac rehabilitation/secondary prevention services[J].Circulation,2010,122(13):1342-1350. [24]ANDERSON L,OLDRIDGE N,THOMPSON D R,et al.Exercise-based cardiac rehabilitation for coronary heart disease:cochrane systematic review and meta-analysis[J].J Am Coll Cardiol,2016,67(1):1-12.DOI:10.1016/j.jacc.2015.10.044. [25]中华医学会心血管病学分会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.冠心病康复与二级预防中国专家共识[J].中华心血管病杂志,2013,41(4):267-275.DOI:10.3760/cma.j.issn.0253-3758.2013.04.003. [26]中华医学会心血管病学分会预防学组,中国康复医学会心血管病专业委员会.冠心病患者运动治疗中国专家共识[J].中华心血管病杂志,2015,43(7):575-588.DOI:10.3760/cma.j.issn.0253-3758.2015.07.004. [27]SMITH D,TOFF W,JOY M,et al.Fitness to fly for passengers with cardiovascular disease[J].Heart,2010,96(Suppl 2):ii1-16.DOI:10.1136/hrt.2010.203091. [28]WRIGHT J T Jr,WILLIAMSON J D,WHELTON P K,et al.A randomized trial of intensive versus standard blood-pressure control[J].N Engl J Med,2015,373(22):2103-2116. [29]WHELTON P K,CAREY R M,ARONOW W S,et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS /APhA/ASH/ASPC/NMA/PCNA guideline for the prevention,detection,evaluation,and management of high blood pressure in adults:a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines[J].J Am Coll Cardiol,2018,71(19):e127-248. [30]American Diabetes Association.9.Cardiovascular disease and risk management:standards of medical care in diabetes-2018[J].Diabetes Care,2018,41(Suppl 1):S86-104.DOI:10.2337/dc18-S009. [31]Cholesterol Treatment Trialists' (CTT) Collaboration,BAIGENT C,BLACKWELL L,et al.Efficacy and safety of more intensive lowering of LDL cholesterol:a meta-analysis of data from 170,000 participants in 26 randomised trials[J].Lancet,2010,376(9753):1670-1681.DOI:10.1016/S0140-6736(10)61350-5. [32]CANNON C P,BLAZING M A,GIUGLIANO R P,et al. Ezetimibe added to statin therapy after acute coronary syndromes[J].N Engl J Med,2015,372(25):2387-2397.DOI:10.1056/NEJMoa1410489. [33]BOHULA E A,MORROW D A,GIUGLIANO R P,et al.Atherothrombotic risk stratification and ezetimibe for secondary prevention[J].J Am Coll Cardiol,2017,69(8):911-921.DOI:10.1016/j.jacc.2016.11.070. [34]SABATINE M S,GIUGLIANO R P,KEECH A C,et al.Evolocumab and clinical outcomes in patients with cardiovascular disease[J].N Engl J Med,2017,376(18):1713-1722.DOI:10.1056/NEJMoa1615664. [35]POCOCK S J,COLLIER T J.Critical appraisal of the 2018 ACC scientific sessions late-breaking trials from a statistician's perspective[J].J Am Coll Cardiol,2018,71(25):2957-2969.DOI:10.1016/j.jacc.2018.04.015. [36]CATAPANO A L,GRAHAM I,DE BACKER G,et al.2016 ESC/EAS guidelines for the management of dyslipidaemias[J].Eur Heart J,2016,37(39):2999-3058.DOI:10.1093/eurheartj/ehw272. [37]GRUNDY S M,STONE N J,BAILEY A L,et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol:a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J].J Am Coll Cardiol,2018,8.pii:S0735-1097(18)39034-X.DOI:10.1016/j.jacc.2018.11.003. [38]胡大一.穿中国鞋 走中国路 圆中国健康梦[J].中华心血管病杂志,2015,43(1):1-2.DOI:10.3760/cma.j.issn.0253-3758.2015.01.001. [39]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-950.DOI:10.3969/j.issn.1000-3614.2016.10.001. [40]BHATT D L,STEG P G,MILLER M,et al.Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia[J].N Engl J Med,2018.[Epub ahead of print].DOI:10.1056/NEJMoa1812792. [41]CURRENT-OASIS 7 Investigators,MEHTA S R,BASSAND J P,et al.Dose comparisons of clopidogrel and aspirin in acute coronary syndromes[J].N Engl J Med,2010,363(10):930-942.DOI:10.1056/NEJMoa0909475. [42]VALGIMIGLI M,BUENO H,BYRNE R A,et al.2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS:the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology(ESC) and of the European Association for Cardio-Thoracic Surgery(EACTS)[J].Eur Heart J,2018,39(3):213-260.DOI:10.1093/eurheartj/ehx419. [43]BERWANGER O,NICOLAU J C,CARVALHO A C,et al.Ticagrelor vs clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction:a randomized clinical trial[J].JAMA Cardiol,2018,3(5):391-399.DOI:10.1001/jamacardio.2018.0612. [44]VALGIMIGLI M,CAMPO G,MONTI M,et al.Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting:a randomized multicenter trial[J].Circulation,2012,125(16):2015-2026.DOI:10.1161/CIRCULATIONAHA.111.071589. [45]BONACA M P,BHATT D L,COHEN M,et al.Long-term use of ticagrelor in patients with prior myocardial infarction[J].N Engl J Med,2015,372(19):1791-1800. [46]MEGA J L,BRAUNWALD E,WIVIOTT S D,et al.Rivaroxaban in patients with a recent acute coronary syndrome[J].N Engl J Med,2012,366(1):9-19.DOI:10.1056/NEJMoa1112277. [47]GIBSON C M,MEHRAN R,BODE C,et al.Prevention of bleeding in patients with atrial fibrillation undergoing PCI[J].N Engl J Med,2016,375(25):2423-2434.DOI:10.1056/NEJMoa1611594. [48]MORROW D A,BRAUNWALD E,BONACA M P,et al.Vorapaxar in the secondary prevention of atherothrombotic events[J].N Engl J Med,2012,366(15):1404-1413.DOI:10.1056/NEJMoa1200933. [49]CANNON C P,BHATT D L,OLDGREN J,et al.Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation[J].N Engl J Med,2017,377(16):1513-1524.DOI:10.1056/NEJMoa1708454. [50]IBANEZ B,MACAYA C,SáNCHEZ-BRUNETE V,et al.Effect of early metoprolol on infarct size in ST-segment-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention:the effect of metoprolol in cardioprotection during an acute myocardial infarction(METOCARD-CNIC) trial[J].Circulation,2013,128(14):1495-1503.DOI:10.1161/CIRCULATIONAHA.113.003653. [51]ROOLVINK V,IBANEZ B,OTTERVANGER J P,et al.Early intravenous beta-blockers in patients with ST-segment elevation myocardial infarction before primary percutaneous coronary intervention[J].J Am Coll Cardiol,2016,67(23):2705-2715. [52]BUGIARDINI R,CENKO E,RICCI B,et al.Comparison of early versus delayed oral beta blockers in acute coronary syndromes and effect on outcomes[J].Am J Cardiol,2016,117(5):760-767.DOI:10.1016/j.amjcard.2015.11.059. [53]GOLDBERGER J J,BONOW R O,CUFFE M,et al.Effect of beta-blocker dose on survival after acute myocardial infarction[J].J Am Coll Cardiol,2015,66(13):1431-1441.DOI:10.1016/j.jacc.2015.07.047. [54]ANDERSSON C,SHILANE D,GO A S,et al.Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease[J].J Am Coll Cardiol,2014,64(3):247-252.DOI:10.1016/j.jacc.2014.04.042. [55]BANGALORE S,STEG G,DEEDWANIA P,et al.Beta-blocker use and clinical outcomes in stable outpatients with and without coronary artery disease[J].JAMA,2012,308(13):1340-1349.DOI:10.1001/jama.2012.12559. [56]ANDREASEN C,ANDERSSON C.Current use of beta-blockers in patients with coronary artery disease[J].Trends Cardiovasc Med,2018,28(6):382-389.DOI:10.1016/j.tcm.2017.12.014. [57]ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group.ISIS-4:a randomised factorial trial assessing early oral captopril,oral mononitrate,and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction[J].Lancet,1995,345(8951):669-685. [58]ACE Inhibitor Myocardial Infarction Collaborative Group.Indications for ACE inhibitors in the early treatment of acute myocardial infarction:systematic overview of individual data from 100,000 patients in randomized trials[J].Circulation,1998,97(22):2202-2212. [59]PFEFFER M A,MCMURRAY J J,VELAZQUEZ E J,et al.Valsartan,captopril,or both in myocardial infarction complicated by heart failure,left ventricular dysfunction,or both[J].N Engl J Med,2003,349(20):1893-1906. [60]PITT B,REMME W,ZANNAD F,et al.Eplerenone,a selective aldosterone blocker,in patients with left ventricular dysfunction after myocardial infarction[J].N Engl J Med,2003,348(14):1309-1321. [61]MONTALESCOT G,PITT B,LOPEZ DE SA E,et al.Early eplerenone treatment in patients with acute ST-elevation myocardial infarction without heart failure:the randomized double-blind reminder study[J].Eur Heart J,2014,35(34):2295-2302. [62]BEYGUI F,CAYLA G,ROULE V,et al.Early aldosterone blockade in acute myocardial infarction:the ALBATROSS randomized clinical trial[J].J Am Coll Cardiol,2016,67(16):1917-1927.DOI:10.1016/j.jacc.2016.02.033. [63]HELD P H,YUSUF S,FURBERG C D.Calcium channel blockers in acute myocardial infarction and unstable angina:an overview[J].BMJ,1989,299(6709):1187-1192. [64]Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial Ⅱ—DAVIT Ⅱ)[J].Am J Cardiol,1990,66(10):779-785. [65]NADERI S H,BESTWICK J P,WALD D S.Adherence to drugs that prevent cardiovascular disease:meta-analysis on 376,162 patients[J].Am J Med,2012,125(9):882–887.e1.DOI:10.1016/j.amjmed.2011.12.013. [66]CASTELLANO J M,SANZ G,PENALVO J L,et al.A polypill strategy to improve adherence:results from the FOCUS project[J].J Am Coll Cardiol,2014,64(20):2071-2082.DOI:10.1016/j.jacc.2014.08.021. [67]SNOW V,BECK D,BUDNITZ T,et al.Transitions of care consensus policy statement American College of Physicians-Society of General Internal Medicine-Society of Hospital Medicine-American Geriatrics Society-American College of Emergency Physicians-Society of Academic Emergency Medicine[J].J Gen Intern Med,2009,24(8):971-976.DOI:10.1007/s11606-009-0969-x. |
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