Виды чрескожных коронарных вмешательств при инфаркте миокарда с подъемом сегмента ST
Abstract
При инфаркте миокарда с подъемом сегмента ST электрокардиограммы (ИМпST) выполняются различные виды чрескожного коронарного вмешательства (ЧКВ) в зависимости от сроков заболевания, сохраняющейся симптоматики болезни и предварительного использования тромболитической терапии (ТЛТ).
Целью настоящего обзора является представить все виды ЧКВ, которые могут быть выполнены при лечении пациентов с ИМпST, обосновать показания для их применения и оптимальный вариант вмешательства.
Принципиально выделять три вида ЧКВ, используемых у больных ИМпST: первичное ЧКВ (пЧКВ), позднее ЧКВ (после 48 часов от начала заболевания и ЧКВ после ТЛТ. Различные виды ЧКВ при ИМпST имеют не одинаковую пользу. Современные рекомендации обосновывают абсолютные показания для стентирования с наивысшим уровнем доказательности для пЧКВ в течение 12 часов, спасительного ЧКВ и рутинного раннего ЧКВ после ТЛТ. При этом приоритетная роль в реперфузии при ИМпST закреплена за пЧКВ в течение 12 часов. Именно поэтому данный показатель является целевым в рамках европейской инициативы Stent for Life (SFL) – национальный/региональный показатель пЧКВ в течение 12 часов должен быть 70% и выше от числа больных, госпитализированных с ИМпST.
About the Authors
Ольга БарбарашRussian Federation
Роман Тарасов
НИИ КПССЗ
Russian Federation
Russian Federation
Арина Данилович
НИИ КПССЗ
Russian Federation
Russian Federation
Владимир Ганюков
НИИ КПССЗ
Russian Federation
Russian Federation
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