Info

🌱 來自: STEMI

Primary PCI

• Definition: immediate PCI upon arrival to hospital or transfer for immediate PCI
• Indic: STE + sx onset w/in <12 h; ongoing ischemia 12–24 h after sx onset; shock
• Superior to lysis: 27% ↓ death, 65% ↓ reMI, 54% ↓ stroke, 95% ↓ ICH (Lancet 2003;361:13)
• Transfer to center for 1° PCI superior to lysis (NEJM 2003;349:733), see below
• PCI of non-culprit lesions (stenoses ≥70% or FFR ≤0.80 if 50–69%) early after event (during initial PCI, prior to or early after d/c) ↓ recurrent MACE, primarily recurrent MI vs. culprit alone (NEJM 2019;381:1411-21); may harm if cardiogenic shock (NEJM 2018;379:1699)