Title：2013 ACCF/AHA Guideline for the Management of ST Elevation Myocardial Infarction (part 1, System and PCI)
题目：2013年美国心脏病基金会学院（ACCF）和美国心脏病协会（AHA）ST段升高心肌梗死（STEMI）治疗指南 (第一部分：体制和PCI)
Author 作者：Feng Xiao 肖锋
Regional system and Primary percutaneous coronary intervention (PCI)
区域性体制和早期经皮冠状动脉介入治疗：
1. Performance of a 12-lead electrocardiogram (ECG) by emergency medical services personnel at the site of first medical contact (FMC) is recommended in patients with symptoms consistent with STEMI.
院前急救人员在现场第一时间内对怀疑STEMI的病人做12导联心电图。
2. Reperfusion therapy should be administered to all eligible patients with STEMI with symptom onset within the prior 12 hours.
在症状出现后12小时内对所有STEMI病人进行再灌注治疗。
3. Primary PCI is the recommended method of reperfusion when it can be performed in a timely fashion by experienced operators.
在有经验操作者时尽快进行早期经皮冠状动脉介入治疗（PCI）。
4. Emergency medical services transport directly to a PCI-capable hospital for primary PCI is the recommended triage strategy for patients with STEMI, with an ideal FMC-to-device time system goal of 90 minutes or less.
EMS要在从到现场到PCI设备90分钟内将病人直接送到有PCI能力的医院。
5. Immediate transfer to a PCI-capable hospital for primary PCI is the recommended triage strategy for patients with STEMI who initially arrive at or are transported to a non–PCI-capable hospital, with an FMC-to-device time system goal of 120 minutes or less.
如果一个STEMI病人就诊于或送到一个不能做PCI的医院，要迅速地在从第一时间接触到PCI设备120分钟内将病人转运到能做PCI医院。
6. In the absence of contraindications, fibrinolytic therapy should be administered to patients with STEMI at non–PCI-capable hospitals when the anticipated FMC-to-device time at a PCI-capable hospital exceeds 120 minutes because of unavoidable delays.
在没有禁忌症情况下，对于在不能做PCI医院或由于不可避免的延误不能在120分钟内将STEMI病人转到有PCI能力的医院，要进行溶栓治疗。
7. When fibrinolytic therapy is indicated or chosen as the primary reperfusion strategy, it should be administered within 30 minutes of hospital arrival.
如果溶栓治疗作为首选再灌注手段，要在病人到达医院30分钟内开始。
8. Reperfusion therapy is reasonable for patients with STEMI and symptom onset within the prior 12 to 24 hours who have clinical and/or ECG evidence of ongoing ischemia. Primary PCI is the preferred strategy in this population.
在12－24小时内，如STEMI病人有临床和／或EKG持续缺血表现，也可以进行再灌注治疗。PCI也是首选的。
9. Primary PCI should be performed in patients with STEMI and cardiogenic shock or acute severe HF, irrespective of time delay from myocardial infarction (MI) onset.
对于合并有心源性休克或急性严重心力衰竭的STEMI病人，不论从发病所耽误的时间有多长，都要进行早期PCI。

Reference 参考文献
J Am Coll Cardiol. 2013; 61(4):485-510.