刘健,熊玮珏,王伟民

• 1:北京大学人民医院心内科

摘要(Abstract)：

<正>对于急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者是否需要常规进行导管血栓抽吸,对于合并多支病变患者行直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)时是否应当同时处理非梗死相关动脉,一直是有争议的两大问题。鉴于大量循证医学证据[1-11],2015年10月,美国心脏病学会

关键词(KeyWords)： 急性ST段抬高心肌梗死;指南解读

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘健,熊玮珏,王伟民

参考文献(References)：

• [1]Vlaar PJ,Mahmoud KD,Holmes DR,et al.Culprit vessel only versus multivessel and staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction:a pairwise and network metaanalysis.J Am Coll Cardiol,2011,58(7):692-703.
• [2]Wald DS,Morris JK,Wald NJ,et al.Randomized trial of preventive angioplasty in myocardial infarction.N Engl J Med,2013,369(12):1115-1123.
• [3]Gershlick AH,Khan JN,Kelly DJ,et al.Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease:the Cv LPRIT trial.J Am Coll Cardiol,2015,65(10):963-972.
• [4]Engstrm T,Kelbk H,Helqvist S,et al.Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease(DANAMI-3-PRIMULTI):an open-label,randomised controlled trial.Lancet,2015,386(9994):665-671.
• [5]Hlinomaz O.Multivessel coronary disease diagnosed at the time of primary PCI for STEMI:complete revascularization versus conservative strategy.PRAGUE 13 trial.Available at:http://sbhci.org.br/wpcontent/uploads/2015/05/PRAGUE-13-Trial.pdf.Accessed September 10,2015.
• [6]Jensen LO,Thayssen P,Farkas DK,et al.Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease.Euro Intervention,2012,8(4):456-464.
• [7]Vlaar PJ,Svilaas T,van der Horst IC,et al.Cardiac death and reinfarction after 1 year in the thrombus aspiration during percutaneous coronary intervention in acute myocardial infarction study(TAPAS):a 1-year follow-up study.Lancet,2008,371(9628):1915-1920.
• [8]Stone GW,Maehara A,Witzenbichler B,et al.Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction:the INFUSE-AMI randomized trial.JAMA,2012,307(17):1817-1826.
• [9]Fr9bert O,Lagerqvist B,Olivecrona GK,et al.Thrombus aspiration during ST-segment elevation myocardial infarction.N Engl J Med,2013,369(17):1587-1597.
• [10]Jolly SS,Cairns JA,Yusuf S,et al.Randomized trial of primary PCI with or without routine manual thrombectomy.N Engl J Med,2015,372(15):1389-1398.
• [11]Elgendy IY,Huo T,Bhatt DL,et al.Is aspiration thrombectomy beneficial in patients undergoing primary percutaneous coronary intervention?Meta-analysis of randomized trials.Circ Cardiovasc Interv,2015,8(7):e002258.
• [12]Levine GN,Bates ER,Blankenship JC,et al.2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention:a report of the American college of cardiology foundation/American heart association task force on practice guidelines and the society for cardiovascular angiography and interventions.J Am Coll Cardiol,2011,58(24):e44-122.
• [13]O'Gara PT,Kushner FG,Ascheim DD,et al.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 Am Coll Cardiol,2013,61(4):e78-140.
• [14]Levine GN,Bates ER,Blankenship JC,et al.2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction:an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the Management of ST-elevation myocardial infarction.J Am Coll Cardiol,2016,67(10):1235-1250.
• [15]Park DW,Clare RM,Schulte PJ,et al.Extent,location,and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction.JAMA,2014,312(19):2019-2027.
• [16]Jensen LO,Thayssen P,Farkas DK,et al.Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease.Euro Intervention,2012,8(4):456-464.
• [17]Anantha NM,Reddy YN,Sundaram V,et al.What is the optimal approach to a non-culprit stenosis after ST-elevation myocardial infarction-Conservative therapy or upfront revascularization?An updated meta-analysis of randomized trials.Int J Cardiol,2016,216:18-24.
• [18]Sianos G,Papafaklis MI,Daemen J,et al.Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction:the importance of thrombus burden.J Am Coll Cardiol,2007,50(7):573-583.
• [19]Toyota T,Shiomi H,Taniguchi T,et al.Culprit vessel-only vs.staged multivessel percutaneous coronary intervention strategies in patients with multivessel coronary artery disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.Circ J,2016,80(2):371-378.
• [20]Watanabe H,Shiomi H,Nakatsuma K,et al.Clinical efficacy of thrombus aspiration on 5-year clinical outcomes in patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention.J Am Heart Assoc,2015,4(6):e001962.
• [21]Desch S,Stiermaier T,de Waha S,et al.Thrombus aspiration in patients with ST-segment elevation myocardial infarction presenting late after symptom onset.JACC Cardiovasc Interv,2016.9(2):113-122.