美国st段抬高性心肌梗死诊断治疗指南PPT.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Lipid Management Routine Medical Therapies Lipid Management High-intensity statin therapy should be initiated or continued in all patients with STEMI and no contraindications to its use. It is reasonable to obtain a fasting lipid profile in patients with STEMI, preferably within 24 hours of presentation. I IIa IIb III I IIa IIb III Complications After STEMI Guideline for STEMI Cardiogenic Shock Complications After STEMI Treatment of Cardiogenic Shock Complications After STEMI Treatment of Cardiogenic Shock Emergency revascularization with either PCI or CABG is recommended in suitable patients with cardiogenic shock due to pump failure after STEMI irrespective of the time delay from MI onset. In the absence of contraindications, fibrinolytic therapy should be administered to patients with STEMI and cardiogenic shock who are unsuitable candidates for either PCI or CABG. I IIa IIb III I IIa IIb III Treatment of Cardiogenic Shock The use of intra-aortic balloon pump counterpulsation can be useful for patients with cardiogenic shock after STEMI who do not quickly stabilize with pharmacological. Alternative LV assist devices for circulatory support may be considered in patients with refractory cardiogenic shock. I IIa IIb III I IIa IIb III Electrical Complications During the Hospital Phase of STEMI Complications After STEMI Implantable Cardioverter-Defibrillator Therapy Before Discharge Complications After STEMI Implantable Cardioverter-Defibrillator Therapy Before Discharge ICD therapy is indicated before discharge in patients who develop sustained VT/VF more than 48 hours after STEMI, provided the arrhythmia is not due to transient or reversible ischemia, reinfarction, or metabolic abnormalities. I IIa IIb III Bradycardia, AV Block, and Intraventricular Conduction Defects Complications After STEMI Pacing in STEMI Complications After STEMI Pacing in STEMI Temporary pac