STEMI溶栓后PCI时机选择策略解析课件.ppt

1、消极治疗阶段60年代以前大内科卧床休息死亡率30%被动治疗阶段70年代CCU建立治疗AMI并发症死亡率15%主动治疗阶段80年代溶栓治疗死亡率7-8%90年代介入治疗死亡率5%全面治疗阶段21世纪后再灌注治疗+辅助治疗新药物和新技术应用死亡率5%p0.001p0.001p=0.01The primary endpoint of mortality was higher in the TNK+PCI treatment group compared with the PCI alone group(6.0%vs 3.8%,p=0.04)at 30 daysAnalysis of mortalit

2、y at 30 days(%)p=0.04 No difference in the frequency of major bleed existed between the two treatment groups(5.7%vs 4.4%)at 30 daysThe presence of any bleeding event(major+minor bleeding)was more common in the TNK+PCI treatment group(31.3%vs 23.4%)at 30 days(p0.001)Analysis of bleeding events at 30

3、days(%)p=0.26p0.001Primary Composite Endpoint at 6 Months(Death,MI,CVA,or severe heart failure)The primary composite endpoint of death,MI,CVA or severe heart failure at 6 months was significantly lower in the rescue PCI group compared with either the repeat thrombolysis group or the conservative management groupRepeatThrombolysisRescue PCI ConservativeManagementp0.001p=0.002