METHOD FOR CARE OF PATIENTS WITH ACUTE CORONARY SYNDROME UNDER CONDITIONS OF MEDICAL INSTITUTION WITH SPECIALIZED DEPARTMENT OF PERCUTANEOUS CORONARY INTERVENTIONS

摘要

FIELD: medicine.;SUBSTANCE: emergency coronary angiography is performed: for patients diagnosed with acute coronary syndrome without ST segment elevation, if at least one of the "high risk factors" is detected; for patients with acute coronary syndrome with ST segment elevation, who did not undergo thrombolytic therapy at the prehospital stage; for patients with acute coronary syndrome with ST segment elevation, who underwent thrombolytic therapy, but it was not effective. Coronary angiography is urgently performed for 3-6 h: for patients with acute coronary syndrome without ST segment elevation, in the absence of "high-risk factors", in the absence of troponin I level elevation, with a GRACE score140; for patients with acute coronary syndrome with ST segment elevation, if the effect of the thrombolytic therapy on prehospital stage is revealed. Coronarography is performed in a delayed manner for 24 hours for patients diagnosed with acute coronary syndrome without ST segment elevation, in the absence of "high risk factors", in the absence of troponin I level increase, with a GRACE score108140, if one of the factors exists; for patients with acute coronary syndrome without ST segment elevation, in the absence of "high-risk factors", in the absence of troponin I increase, with a GRACE score108140, in the absence of one of the factors. Coronarography is not performed: for patients with acute coronary syndrome without ST segment elevation, in the absence of "high risk factors", in the absence of troponin I increase, with a GRACE score of 108.;EFFECT: method allows to reduce hospital lethality and risk of haemorrhagic complications, and allows to make a decision in a short time about the timeliness and urgency of coronary angiography and intermittent coronary intervention according to its results.;1 dwg