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🌱 來自: STEMI

Nonprimary PCI

• Rescue PCI if shock, unstable, failed reperfusion, or persistent sx (NEJM 2005;353:2758)
• Routine angio ± PCI w/in 24 h of successful lysis: ↓ D/MI/revasc (Lancet 2004;364:1045) and w/in 6 h ↓ reMI, recurrent ischemia, & HF compared to w/in 2 wk (NEJM 2009;360:2705); ∴ if lysed at non-PCI-capable hosp., consider transfer to PCI-capable hosp.. ASAP espec if high-risk (eg, ant. MI, IMI w/ ↓ EF or RV infarct, extensive STE/LBBB, HF, ↓ BP or ↑ HR)
• Late PCI (median day 8) of occluded infarct-related artery: no benefit (NEJM 2006;355:2395) Antiplatelet Therapy of STEMI Anticoagulant Therapy (choose one) LV failure (occurs in ~25%) IMI complications (Circ 1990;81:401; NEJM 1994;330:1211; JACC 2003;41:1273) Mechanical complications (incid. <1% for each; typically occur a few days post-MI) Arrhythmias post MI (treat all per ACLS protocols if unstable or symptomatic) Other Post MI Complications