超过再灌注治疗时间窗的stemi患者的介入治疗策略选择

超过再灌注治疗时间窗的stemi患者的介入治疗策略选择内容摘要：

th symptoms for less than 12 hours Antman EM et al., AHA/ACC STEMI guidelines 2020: Circulation 2020。 117:296329. Background  Primary PCI is remended for the treatment of STEMI in patients presenting with symptoms for less than 12 hours Antman EM et al., AHA/ACC STEMI guidelines 2020: Circulation 2020。 117:296329.  However, % of STEMIpatients are ”late presenters” with symptoms for more than 12 hours on admission Schomig A et al., Eur Heart J 2020。 27:19001907 Background  BRAVE2 is the only trial on primary angioplasty vs. medical therapy in STEMIpatients with symptoms for 1248 hours on admission Schomig A et al., JAMA 2020。 293:28652872 Parodi G et al., Am Heart J 2020。 152:11331139 Background  BRAVE2 is the only trial on primary angioplasty vs. medical therapy in STEMIpatients with symptoms for 1248 hours on admission Schomig A et al., JAMA 2020。 293:28652872 Parodi G et al., Am Heart J 2020。 152:11331139  Final infarct size: Primary PCI vs. Medical therapy: p Background 8% 13%  BRAVE2 is the only trial on primary angioplasty vs. medical therapy in STEMIpatients with symptoms for 1248 hours on admission Schomig A et al., JAMA 2020。 293:28652872 Parodi G et al., Am Heart J 2020。 152:11331139  Salvage index (% of risk area salvaged): Primary PCI vs. Medical therapy: p Background 44% 23%  To evaluate if the 12hour limit is a relevant cutoff point for offering primary angioplasty Aim  Late presenters (1272 h) do not achieve myocardial salvage after primary angioplasty and therefore develop larger final infarct sizes than early presenters (12 h) Hypothesis  Symptom duration was defined as time from onset of symptoms to first balloon inflation = paintoballoon interval Definition of symptom duration Myocardial scintigraphy before primary PCI: Myocardial scintigraphy 30 days later: Salvage = 465 = 41% of LV myocardium Salvage index = 41/46 = 89% of area at risk Area at risk = 46% Infarct size = 5% Method: Myocardial scintigraphy 1) Ndrepepa G, J Nucl Med 2020。 45:725729。 2) Burns RJ, JACC 2020。 39:306  Primary oute: Infarct size (% of LV)  Power calculation*: 12 h: Infarct size = 15177。 10%: n=200 1272 h: In。