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aha acc与esc stemi相关指南更新.ppt


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STEMI现代观点与临床实践 —AHA/ACC与ESC相关指南更新
1
2
Hospitalizations in the . Due to Acute Coronary Syndromes (ACS)
Acute Coronary Syndromes*
Million Hospital Admissions - ACS
UA/NSTEMI†
STEMI
million Admissions per year
.33 million Admissions per year
Heart Disease and Stroke Statistics – 2007 Update. Circulation 2007; 115:69-171. *Primary and secondary diagnoses. †About million NSTEMI and million UA.
3
Descriptive Epidemiology of STEMI
Heart Disease and Stroke Statistics – 2009 Update. Circulation 2009; 119:e21-e181. *Primary and secondary diagnoses. †About million NSTEMI and million UA.
The percentage of ACS or MI with ST elevation varies in
different registries/databases
Registry
% of MI which are STEMI
National Registry of Myocardial Infarction (NRMI-4)
29%
AHA Get with the Guidelines
32%
Global Registry of Acute Coronary Events (GRACE)
38%
4
Class I Benefit >>> Risk
Procedure/ Treatment SHOULD be performed/ administered
Class IIa Benefit >> Risk Additional studies with focused objectives needed
IT IS REASONABLE to perform procedure/administer treatment
Class IIb Benefit ≥ Risk Additional studies with broad objectives needed; Additional registry data would be helpful
Procedure/Treatment
MAY BE CONSIDERED
Class III
Risk ≥ Benefit No additional studies needed
Procedure/Treatment should NOT be performed/administered SINCE IT IS NOT HELPFUL AND MAY BE HARMFUL
should
is mended
is indicated
is useful/effective/ beneficial
is reasonable
can be useful/effective/ beneficial
is probably mended or indicated
may/might be considered
may/might be reasonable
usefulness/effectiveness is unknown /unclear/uncertain or not well established
is not mended
is not indicated
should not
is not useful/effective/beneficial
may be harmful
Applying Classification of mendations and Level of Evidence
Class I Benefit >>> Risk
Procedure/ Treatment SHOULD be performed/ administered
Class IIa Benefit >> Risk Additional s

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  • 时间2018-05-16