AMI

2012. 6. 2

---

24

(1)Chest pain center CPC

(2)ACSSTEMIIRAAAD4850%

PTE

(3)30002002.1024 0531-82169595

---24

AMIPCI+PCI(1)PCISTSTEMIAMI

AMIPCI+PCI(2)PCITIMI380%

PCIIRA

--

120

ECG6h

(1)

(2)10%-30%

---

ST ST CK CK CKCK Q Q Q / Q ST ST

(vulnerable patient)--: (vulnerable plaque): (vulnerable blood): (vulnerable myocardium):

Naghavi M et al. Circulation,2003;108:1664

ST (ST ST) (VF, VT)

STT, ECG

ECG STGPIIb/IIIa -(ACS)

---

PCI

PCI2008ACCTransfer --AMISTEMIPCIPCIMACEPCI

2010STEMI2PCIPCIPCI3-24PCI

CAPTIM Bonnefoy, E., F. Lapostolle, A. Leizorovicz, et al., Lancet, 2002. 360(9336): p. 825-9.Bonnefoy, E., et al., (CAPTIM) trial: a 5-year follow-up. Eur Heart J, 2009. 30(13): p. 1598-606.STEMI(N=840)PCI(n=419)PCI(n=421)

30 -- 5

%+PCI 30 +PCI5(5.8% vs 11.1% ,P=0.04) p=0.06p=0.12p=0.13p=0.29p=0.61** --Bonnefoy, E., F. Lapostolle, A. Leizorovicz, et al., Lancet, 2002. 360(9336): p. 825-9.

PCIPCI/

PCI

PCI1999PACTPCIPCI

GPb /aPCI

ADMIRALPCIn=300PCITIMI 3P=0.0130)P=0.01

/GPb/aPCI2008 ACCON-TIME 2STEMIPCI1STR30MACE PCI

AMIAMI(1)

AMIAMI(2)24

--

*CAPTIM PCIPCISTEMIPCIPCI30-- 5*30--