о допплере

[Yariko]

Сообщение от Chevychelov

Я так понял перевод из АСС/АНА для СТЕМИ:
Renin-Angiotensin-Aldosterone System Blockers

ACE inhibitors in all patients indefinitely; start early in stable high-risk patients (anterior MI, previous MI, Killip class greater than or equal to II [S3 gallop, rales , radiographic CHF], LVEF less than 0.40).

Простите за дотошность, я просмотрела рекомендации АСС/AHA. Представленный Вами фрагмент из рекомендаций 2004 года, они были пересмотрены в 2007 году. [Ссылки доступны только зарегистрированным пользователям ]

В пересмотре раздел ингибиторы АПФ был изменен и уточнен:
1. ACE inhibitors should be started and continued indefinitely in all patients recovering from STEMI with LVEF less than or equal to 40% and for those with hypertension, diabetes, or chronic kidney disease, unless contraindicated.
I (A) Modified recommendation
(changed text)
2. ACE inhibitors should be started and continued indefinitely in patients recovering from STEMI who are not lower risk (lower risk defined as those with normal LVEF in whom cardiovascular risk factors are well controlled and revascularization has been performed), unless contraindicated.
I (B) New recommendation
3. Among lower risk patients recovering from STEMI (i.e., those with normal LVEF in whom cardiovascular risk factors are well controlled and revascularization has been performed) use of ACE inhibitors is reasonable.
IIa (B) New recommendation

[Chevychelov]

Если я не ошиаюсь почти полное совпадение с европейскими рекомендациями - высокий риск и не низкий риск класс1, низкий риск класс 2а.

[Yariko]

Сообщение от Chevychelov

Если я не ошиаюсь почти полное совпадение с европейскими рекомендациями - высокий риск и не низкий риск класс1, низкий риск класс 2а.

Да, я тоже заметила

[Yariko]

Прошу прощения, что выхожу за рамки темы, но хотела бы обратить внимание коллег на следущие положения пересмотра рекомендаций АСС/AHA по STEMI от 2007, которые показались мне интересными:
Antiplatelet Agents/Anticoagulants: Aspirin
1. For all post-PCI STEMI stented patients without aspirin resistance, allergy, or increased risk of bleeding, aspirin 162 mg to 325 mg daily should be given for at least 1 month after BMS implantation, 3 months after sirolimus-eluting stent
implantation, and 6 months after paclitaxel-eluting stent implantation, after which long-term aspirin use should be continued indefinitely at a dose of 75 mg to 162 mg daily.
I (B) Modified recommendation
(changed text)
2. In patients for whom the physician is concerned about risk of bleeding lower-dose 75 mg to 162 mg of aspirin is reasonable during the initial period after stent implantation.
IIa (C) New recommendation
Antiplatelet Agents/Anticoagulants: Clopidogrel
2. For all STEMI patients not undergoing stenting (medical therapy alone or PTCA without stenting), treatment with clopidogrel should continue for at least 14 days.
I (B) New recommendation
3. Long-term maintenance therapy (e.g., 1 year) with clopidogrel (75 mg per day orally) is reasonable in STEMI patients regardless of whether they undergo reperfusion with fibrinolytic therapy or do not receive reperfusion therapy.
IIa (C) New recommendation