非STセグメント上昇急性冠動脈症候群の管理に対する簡素化されたアプローチ
Ty J Gluckman1, Molly Sachdev, Steven P Schulman
1Division of Cardiology, the Johns Hopkins Hospital, Baltimore, Md, USA.
JAMA
|January 20, 2005
まとめ
医師は,証拠に基づいた"ABCDE"アプローチを使用して,非STセグメント上昇急性冠動脈症候群 (NSTE-ACS) のケアを改善することができます. このシステマティックな方法は,冠動脈疾患の管理におけるより良い患者の結果のためのガイドラインの実施を簡素化します.
科学分野:
- 心臓病学 心臓病学
- 根拠に基づいた医学は,証拠に基づいた医療です.
- クリニカル・プラクティスのガイドライン
背景:
- 現在の急性冠動脈症候群 (ACS) のガイドラインは,証拠に基づいた管理戦略を提供しています.
- これらのガイドラインの医師による適用は最適以下であり,実施の改善の必要性を示しています.
研究 の 目的:
- 非STセグメントの高さACS (NSTE-ACS) の最適な管理のための証拠を評価し,合成する.
- NSTE-ACSのケアにおいて,エビデンスベースの医療を適用するための実践的な枠組みを提供すること.
主な方法:
- MEDLINEとコクランデータベース (1990-2004) の体系的な文献検索 (1990-2004).
- NSTE-ACSの臨床管理に係る制御された英語研究を含む.
- 専門家の相談と,ジャーナルと臨床的関連性に基づくデータ品質評価.
主要な成果:
- 制御された研究は,NSTE-ACS管理に対する包括的なアプローチを支持しています.
- 医者は,現在のガイドラインが長く複雑だと考えています.
- "ABCDE"アプローチは,リスクの階層化後に包括的な管理計画を容易にします.
結論:
- "ABCDE"アプローチは,NSTE-ACS.を管理するための実践的かつ体系的な方法を提供します.
- このフレームワークは,NSTE-ACS.の臨床実践にエビデンスベースの医療を導入するのに役立ちます.
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