【摘要】 老年人非ST段抬高急性冠脉综合征和ST段抬高性心肌梗死的共同问题包括症状不典型、合并危险因素多、临床证据不充分。老年人非ST段抬高急性冠脉综合征早期给予经皮冠状动脉介入治疗减少死亡或心肌梗死绝对和相对危险度,长期随访显示其改善生存和症状的优越性。老年人ST段抬高性心肌梗死介入治疗主要获益来自减少再次心肌梗死和重复血运重建;再灌注及时性和可行性是挽救濒危心肌和改善临床预后的重要因素;选择经皮冠状动脉介入治疗或溶栓取决于患者是否存在心源性休克、时间延搁、合并病等因素,多数情况下倾向选择经皮冠状动脉介入治疗。年龄是老年人急性冠脉综合征介入治疗临床疗效的重要影响因素。更多还原

【Abstract】 Atypical presentations,risk factors,and limited research are common themes in the management of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment-elevation acute coronary syndrome (NSTE ACS) in the elderly. The elderly with NSTE ACS demonstrate greater absolute and relative benefits in reducing death or myocardial infarction (MI) with early percutaneous coronary intervention (PCI). The long-term monitoring of patients who have undergone PCI suggests that PCI is a superior treatment for improving both symptoms and chances of survival. The major benefit of PCI for the elderly with STEMI is a reduction in future instances of re-infarction and repeated target-vessel revascularization. Regardless of strategy,however,the availability of,and time to,reperfusion,in combination with a patient’s age are the key determinants of outcome and benefits.更多还原