臧雁翔,李为民

• 1:哈尔滨医科大学附属第一医院心内科

摘要(Abstract)：

<正>《2020年欧洲心脏病学会非ST段抬高型急性冠状动脉综合征管理指南》~([1])是对于2015年欧洲心脏病学会(European Society of Cardiology,ESC)指南~([2])的更新,该指南对非ST段抬高型急性冠状动脉综合征(non-STE acute coronary syndrome,NSTE-ACS)的诊断、风险评估、药物治疗、侵入性治疗策略等进行阐述,同时增加了冠状动脉非阻塞性心肌梗死(myocardial infarction with non-obstructive coronary arteries,MINOCA)等内容。以下将结合国内外相关指南、专家共识或建议以及我国现状等对《2020年ESC NSTE-ACS管理指南》(以下简称为《2020 ESC NSTE-ACS指南》)进行解读,同时分析其不足之处。

关键词(KeyWords)： 非ST段抬高型急性冠状动脉综合征;冠状动脉非阻塞性心肌梗死

Abstract:

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基金项目(Foundation):

作者(Author): 臧雁翔,李为民

参考文献(References)：

• [1] Collet JP, Thiele H, Barbato E,et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J,2020.[Online ahead of print]
• [2] Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:Task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC). Eur Heart J,2016,37(3):267-315.
• [3] Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction(2018). Circulation,2018,138(20):e618-e651.
• [4]中华医学会心血管病学分会介入心脏病学组，中国医师协会心血管内科医师分会血栓防治专业委员会，中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南（2016）.中华心血管病杂志，2016,44(5):382-400.
• [5] Montalescot G, Bolognese L, Dudek D, et al. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med,2013,369(11):999-1010.
• [6] Wang JY, Zhang YJ, Li H, et al. CRISPLD1 rs12115090polymorphisms alters antiplatelet potency of clopidogrel in coronary artery disease patients in Chinese Han. Gene,2018,678:226-232.
• [7] Misumida N, Aoi S, Kim SM, et al. Ticagrelor versus clopidogrel in East Asian patients with acute coronary syndrome:Systematic review and meta-analysis. Cardiovasc Revasc Med,2018,19(6):689-694.
• [8] Angiolillo DJ, Goodman SG, Bhatt DL, et al. Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention:A north American perspective-2018 update. Circulation,2018,138(5):527-536.
• [9]中华医学会心血管病学分会，中华心血管病杂志编辑委员会.冠心病合并心房颤动患者抗栓管理中国专家共识.中华心血管病杂志，2020,48(7):552-564.
• [10]中国医师协会急诊医师分会，国家卫健委能力建设与继续教育中心急诊学专家委员会，中国医疗保健国际交流促进会急诊急救分会.急性冠脉综合征急诊快速诊治指南（2019）.中华急诊医学杂志，2019,28(4):421-428.
• [11]中华医学会心血管病学分会，中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南（2019）.中华心血管病杂志，2019,47(10):766-783.
• [12] Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J,2020,41(3):407-477.
• [13] Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med,2004,350(7):655-663.
• [14] Vasan RS, Benjamin EJ, Larson MG, et al. Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction:the Framingham heart study. JAMA,2002,288(10):1252-1259.