STEMI现代观点与临床实践—AHA/ACC与ESC相关指南更新 1 2 Hospitalizations in the . Due to Acute Coronary Syndromes (ACS) Acute Coronary Syndromes* Million Hospital Admissions - ACS UA/NSTEMI† STEMI million Admissions per year .33 million Admissions per year Heart Disease and Stroke Statistics – 2007 Update. Circulation 2007; 115:69-171. *Primary and secondary diagnoses. †About million NSTEMI and million UA. 3 Descriptive Epidemiology of STEMI Heart Disease and Stroke Statistics – 2009 Update. Circulation 2009; 119:e21-e181. *Primary and secondary diagnoses. †About million NSTEMI and million UA. The percentage of ACS or MI with ST elevation varies in different registries/databases Registry % of MI which are STEMI National Registry of Myocardial Infarction (NRMI-4) 29% AHA Get with the Guidelines 32% Global Registry of Acute Coronary Events (GRACE) 38% 4 Class I Benefit >>> Risk Procedure/ Treatment SHOULD be performed/ administered Class IIa Benefit >> RiskAdditional studies with focused objectives needed IT IS REASONABLE to perform procedure/administer treatment Class IIb Benefit ≥ RiskAdditional studies with broad objectives needed; Additional registry data would be helpful Procedure/Treatment MAY BE CONSIDERED Class III Risk ≥ BenefitNo additional studies needed Procedure/Treatment should NOT be performed/administered SINCE IT IS NOT HELPFUL AND MAY BE HARMFUL should is mended is indicated is useful/effective/ beneficial is reasonable can be useful/effective/ beneficial is probably mended or indicated may/might be considered may/might be reasonable usefulness/effectiveness is unknown /unclear/uncertain or not well established is not mended is not indicated should not is not useful/effective/beneficial may be harmful Applying Classification of mendations and Level of Evidence Class I Benefit >>> Risk Procedure/ Treatment SHOULD be performed/ administered Class IIa Benefit >> RiskAdditional s
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