LINEBURG


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Philip Urban, Director, Interventional Cardiology Hopital de la Tour
Meyrin-Geneva Switzerland
259
Edoardo De Benedetti, Cardiologist
C.H.U.V. Lausanne Switzerland
Oaaeeoa 1. N?aaieoaeuiay yooaeoeaiinou e aac iianiinou noaiaa?oiiai ea?aiey no?aioieeiac ie e ?ac ee?iuo noai
o?iiaieec ena n eniieuc iaaieai oeaiaaiai aeoeaaoi?a ieac ieiiaaia (OAI) i?e i?aaiieaaaaiii ino?ii eioa?eoa
ieiea?aa: ?ac oeuoaou eniuoaiee GISSI-2 [10], ISIS-3 [11] e GUSTO-1 [12] (i?eaiaeony n ?ac?aoaiey ec aaoaey ii:
Collins R., Peto R., Baigent B.M., Sleight D.M. Aspirin, heparin and fibrinolytic therapy in suspected AMI. N Engl J Med
1997;336:847—60) [18—20]




I?iaie?aiea oaae. 1 ia neaa. no?.





260
I?iaie?aiea oaae. 1




I?eia?aiey e oaae. 1 ia neaa. no?.





261
I?eia?aiea e oaae. 1. Yoo oaaeeoo iaeucy eniieuciaaou aey i?yiuo ia?aiaiiece?iaaiiu o n?aaiaiee ?anoiou ?aca eoey oiai eee
eiiai eeeie?aneiai enoi aa a ?ace e?iuo eni uoaieyo, iineieueo a?oiiu a ieuiuo ii aoo cia?e oaeuii ?acee?aouny ii aic?anoo e
a?oaei iieacaoaeyi. Nia?oiinou a eniuoaieyo GISSI-2 e ISIS-3 ioaieaaee a oa?aiea ia?auo 35 aiae, a eniuoaiee GUSTO-1 — a
oa?ai ea ia?au o 30 aiae. ?enei ?aiaiie ce?iaaii uo e ?enei iaae?a aaoeony a aaeuiaeoai aie uiuo i?e aiayony ii io?aoai ia
eniuoaieyo ISIS-3 [19] e GUSTO-1 [20], aee??ay iioaeeeiaaiiua ia?aniio?aiiua ?acoeuoaou eniuoaiey GUSTO-1 (iioaeeeiaai-
iua National Auxiliary Publication Service); ?enei e aiey (a % io ?enea iaae?aaaoeony aieuiuo) ca?aaeno?e?iaaiiuo enoiaia i?eai-
ayony ii io?aoo eniuoaiey ISIS-3 [20] e ioaeeeaoee F. Van de Werf et al. [50]. Aeaiacii cia?aiee iieacaoaeae i?aanoaaeai a aeaa
n?aaiae±noaiaa?oiia ioeeiiaiea. Ai anao 3 eniuoaieyo no?aioi eeiaco aaiaeee a/a eaiaeuii (1,5 iei IA a oa?aiea 1?). OAI —
oeaiaaue aeoeaaoi? ieacieiiaaia; a/a — aioo?eaaiii; i/e — iiaei?ii.
* — nia?ou, i?e eioi?ie einoeuo ia aue iaia?o?ai;
** — a yoii eniuoaiee OAI aaiaeee a/a ii neaao?uae noaia: nia?aea 10 ia no?oeii, caoai 50 ia a oa?aiea 1-ai ?ana e ii 20 ia a
oa?aiea 2-ai e 3-ai ?ania;
*** — a yoii eniuoaiee OAI aa iaeee a/a ii neaao?uae noaia: nia?ae a ii 40 000 AA/ea no? oeii, caoai ii 3 60 00 0 aae ieo
o?iiaieeoe?aneie aeoeaiinoe/ea a oa?aiea 1-ai ?ana e ii 67 000 aaeieo o?iiaieeoe?aneie aeoeaiinoe/ea a oa?aiea 3 iineaao?ueo
?ani a;
#
— a yoii eniuoaiee i?e iiiioa?aiee OAI aaiaeee a/a ii neaao?uae noaia: nia?aea 15 ia no?oeii, caoai ii 0,75 ia/ea (ii ia
aieaa 50 ia) a ia?aua 30 iei e ii 0,5 ia/ea (ii ia aieaa 35 ia) a oa?aiea neaao?uaai ?ana; i?e eiiaeie?iaaiiie o?iiaieeoe?an-
eie oa?aiee OAI nia?aea aaiaeee a/a no?oeii ii 0,1 ia/ea (ii ia aieaa 9 ia), caoai ii 0,9 ia/ea (ii ia aieaa 81 ia) a ni?aoaiee ni
no?aioieeiacie (1 iei IA) a oa?aiea 1 ?;
##
— aan ea?aiai e niuoaiey a ue i?iii?o eiiaeai ?acia?o auai? ee, iiyoiio iaeaieuo ee aan eiaao eniuoai ea GUSTO-1 , iae-
iaiuoee — GISSI-2 [17].





262
Oaaeeoa 2. N?aaieoaeuiia aeeyiea ?aiiae eaoaoa?ec aoee na?aoa e eaea?noaaiiie oa?aiee aac aiiieieoaeuiuo aia-
oaoaeunoa ia nia?oiinou a ia?aua 30 noo, 6 ian, 12 ian iinea ino?iai eioa?eoa ieiea?aa [2, 3, 55]





263




I (2073 )


II (594 )
, %




III (165 )




IV (69 )




0 1 2 3 4 5 6 7 8 9 10 >10
,




?en. 1. Iino?iaiiua ii aaiiui ?aano?a AMIS e?eaua au?eaaaiinoe Eaieaia—
Iaea?a a c aaeneiinoe io eeanna na?aa?iie iaainoaoi?iinoe ii Eeeeeio a iiiaio
ainieoaeec aoee a nayc e n ino?ui EI (3138 aieuiuo, 50 eeeiee a Oaaeoa?ee,
1977—1998 aa.) I?eaiaeony n ?ac?aoaiey aaoi?ia [9].




264





— ( 1 )





10%
, %




5%


A C A C A C A C
92 203 32 54 871 1094 874 1102
9328 9325 9094 9095 9388 9385 9388 9385
(1,0%) (2,2%) (0,4%) (0,6%) (9,3%) (11,7%) (9,3%) (11,7%)




0%


-
:



0,2% 2,4% 2,4%
, % 1,2%
(1,6%—3,2%)
(0,05%—0,4%) (1,6%—3,1%)
(95% ) (0,9%—1,4%)



413 42 41
84
(31—62)
(273—2025) (32—64)
(95% ) (71—109)


41% 20% 21%
%
, 55%
(14%—27%)
(8%—62%) (13%—27%)
(95% ) (42%—65%)



?en. 2. Eeeie?aneea enoiau i?e i?iaaaaiee aioeaa?aaaioiie oa?aiee o aieuiuo
n iiaoaa??aaiiui eee i?aaiieaaaaiui ino?ui EI (i?eaiaeony n ?ac ?aoaiey aa-
oi?ia ii [11]).
Aunioa noieaeeia niioaaonoaoao aanie?oiiio ?eneo ?acaeoey inei?iaiee ca 1 ian aey ea?aie
a?oiiu; aa?oeeaeuiua eeiee iaicia?a?o aa?oi?? iieiaeio 95% AE. A noieaeea “Nia?ou io
e?auo i?e?e i” ie?iea ai?eciioaeu iua eeiee iaicia?a?o nia?oiinou, ia naycaiio? n na?-
aa?ii-ninoaenouie caai eaaaieyie. A oaaeeoa aey ea?aiai aeaa enoia ia i?aanoaaeaiu cia?a-
iey NA?, ?AIE ca 1 ian e NI? n 95% AE. I?eaiaeony n ?ac?aoaiey aaoi?ia [11].




265





:
1,6—0,6 1000
1000 ,




3000





14 000



12 000


9000




7000




6 12 18 24
,




?en. 3. Aeeyiea n?ieia i?iaaaaiey o?iiaieec ena ia aai yooaeoeaiinou, ioaieaaa-
io? ?a?ac 1 ian (ii ?ac oeuoaoai iaae?aaiey 45 000 aieuiuo n ino?ui EI e iiaua-
iii naaiaioa ST eee aeieaaie ii?ae io?ea Aena [15]).
Oeo?u ia e? eaie niioaaonoao?o ?e neo aieuiuo, eioi?ui i?iaiaeee o?iiaieece n a oeacai-
iua n?iee. I?eaiaeony n ?ac?aoaiey aaoi?ia [17].




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