Phân tầng nguy cơ trong hội chứng vành cấp

European Heart Journal Advance Access published August 29, 2015 2015 ESC Guidelines for the management of ACS without persistent ST-segment elevation... 2015 ESC Guidelines for the mana

PHÂN TẦNG NGUY CƠ VÀ CHIẾN LƯỢC ĐIỀU TRỊ TRONG HỘI CHỨNG VÀNH CẤP:

KHI NÀO NÊN CAN THIỆP MẠCH VÀNH?

GS TS BS Võ Thành Nhân

ĐH Y Dược – BV Chợ Rẫy TP HCM

Calculating GRACE Risk Score

≥130 19

Heart Points rate

≤70 10 70-89 15 90-109 26 110-129 32 130-149 24 150-169 16 170-199 8

≥200 0

Age Points

≤30 0 30-49 10 50-69 29 70-79 56 80-89 73

≥90 91

Creatinine Points

0-0.39 3 0.4-0.9 9 1.0-1.9 32

≥2 51

Baseline risk factors Points

Cardiac arrest at admission 38

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

European Heart Journal Advance Access published August 29, 2015

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2015 ESC Guidelines for the management of ACS

without persistent ST-segment elevation

2013 ACCF/AHA Guideline for the

Primary PCI in STEMI

Indications for Transfer for Angiography After

Fibrinolytic Therapy

*Although individual circumstances will vary, clinical stability is defined by the absence of low output, hypotension, persistent tachycardia, apparent shock, high-grade ventricular or symptomatic supraventricular tachyarrhythmias, and spontaneous recurrent ischemia

Indications for PCI of an Infarct Artery in Patients Who Were Managed With Fibrinolytic Therapy or Who Did

Not Receive Reperfusion Therapy

*Although individual circumstances will vary, clinical stability is defined by the absence of low output, hypotension, persistent tachycardia, apparent shock, high-grade ventricular or symptomatic

supraventricular tachyarrhythmias, and spontaneous recurrent ischemia

PCI of a Noninfarct Artery Before

Hospital Discharge

PCI is indicated in a noninfarct artery at a time separate from primary PCI in patients who have spontaneous symptoms of myocardial ischemia

PCI is reasonable in a noninfarct artery at a time separate from primary PCI in patients with

intermediate- or high-risk findings on noninvasive testing

I IIa IIb III

I IIa IIb III

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