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By T. Garth Connelly

Squadron-Signal Warships In motion 4013 - Vosper Mtbs КНИГИ ;ВОЕННАЯ ИСТОРИЯ издательство: Squadron SignalТип:pdfФормат: rarРазмер: 24,3 MbКол-во страниц: fifty one+ three% информации для востановления архива. eighty five

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Vosper Mtbs

Squadron-Signal Warships In motion 4013 - Vosper Mtbs КНИГИ ;ВОЕННАЯ ИСТОРИЯ издательство: Squadron SignalТип:pdfФормат: rarРазмер: 24,3 MbКол-во страниц: fifty one+ three% информации для востановления архива. eighty five

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REFERENCES 1. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomized trials. Lancet 2003; 361:13–20. 2. De Luca G, Biondi-Zoccai G, Marino P. Transferring patients with ST-segment elevation myocardial infarction for mechanical reperfusion: A meta-regression analysis of randomized trials. Ann Emerg Med 2008; 52:665–676. 3. Antman EM, Hand M, Armstrong PW, et al. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: Developed in collaboration with the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee.

Tirofiban significantly improved ECG parameters (ST-segment resolution) compared to placebo. Other trials have focused on the use of “mandatory” rescue-PCI in patients initially treated with thrombolytic therapy, and two trials (31,32) indicate that the immediate transfer (a so-called pharmacoinvasive strategy) is effective in reducing morbidity. The CARESS-in-AMI (32) included high-risk patients with acute STelevation MI and symptoms less than 12 hours at non-PCI capable hospitals. All patients received half-dose reteplase, abciximab, unfractionated heparin, clopidogrel, and aspirin before randomization to two groups: immediate transfer to PCI at a tertiary center (n = 299) or continued care at a non-PCI hospital (n = 301) with transfer for PCI only if clinical deterioration or lack of ST-resolution occurred.

In this study, a total of 425 patients were transferred (8). 7% Which Patients Should Be Transferred for Primary PCI? 4% risk of ventricular arrhythmias and a 2% risk of development of second or third degree heart block (10). It is obvious that the criteria for selection of patients for transfer are very important. In the DANAMI-2 trial, 4% of patients screened were excluded, as they were deemed ineligible for transport. However, the SHOCK trial indicated that patients in cardiogenic shock constitute a group of STEMI patients that benefit the most from primary PCI (13).

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