《2023 AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠状动脉疾病患者管理指南》要点解读  

Interpretation of Key Points of 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients with Chronic Coronary Disease

作　　者：薛亚男 欧敏行 张秀杰[1] 孟庆雪 刘莹[3] XUE Yanan;OU Minxing;ZHANG Xiujie;MENG Qingxue;LIU Ying(Department of Heart Failure and Hypertension,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Dalian Medical University,Dalian 116044,China;Department of Heart Failure and Structural Cardiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China*Corresponding author:)

机构地区：[1]大连医科大学附属第一医院心力衰竭与高血压科,辽宁省大连市116011 [2]大连医科大学,辽宁省大连市116044 [3]大连医科大学附属第一医院心力衰竭与结构性心脏病科,辽宁省大连市116011

出　　处：《中国全科医学》2024年第18期2173-2178,2191,共7页Chinese General Practice

基　　金：国家自然科学基金重点项目(U1908209)。

摘　　要：慢性冠状动脉疾病是指因心脏流入或流出血流不足所引起的慢性心脏或血管疾病,发病率与死亡率居高不下,导致巨大的个人、经济与社会负担。2023年7月美国心脏协会(AHA)、美国心脏病学会(ACC)等6个学术组织联合发布了《2023 AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠状动脉疾病患者管理指南》,该指南提供了一种以循证为基础和以患者为中心的方法综合管理慢性冠状动脉疾病患者,内容涉及慢性冠状动脉疾病的流行病学,以及对患者的评估、诊断与风险分层、治疗、特殊人群管理,患者随访和相关注意事项等建议,强调了健康饮食、规律体育锻炼和远离烟草对心血管健康的重要性,并且更新了钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽-1受体激动剂等药物的相关治疗推荐,为临床工作提供了最新的基于循证医学证据的建议。本文对该指南的管理策略进行要点解读,旨在为国内相关指南的制订与更新提供依据,不断规范与完善慢性冠状动脉疾病患者的专科诊疗照护,以期为临床实践提供循证指导,改善慢性冠状动脉疾病患者的预后。Chronic coronary disease(CCD)refers to chronic heart or vascular disease caused by insufficient blood flow into or out of the heart.The incidence and mortality rates of CCD are high,resulting in significant personal,economic,and societal burdens.In July 2023,the American Heart Association(AHA)and the American College of Cardiology(ACC),along with other academic organizations,jointly released the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients with Chronic Coronary Disease.This guideline provides a on the evidence-based and patientcentered approach to comprehensive management of patients with CCD.It covers the epidemiology of CCD,patient assessment,diagnosis,risk stratification,treatment,management of special populations,patient follow-up,and related considerations.The guideline emphasizes the importance of a healthy diet,regular physical exercise,and tobacco avoidance for cardiovascular health.It also updates the recommendations for the use of sodium-glucose cotransporter-2 inhibitors(SGLT2i)and glucagon-like peptide-1 receptor agonists(GLP-1RA)and provides the latest evidence-based recommendations for clinical practice.This article provides a key interpretation of the management strategies outlined in the guideline,aiming to provide a basis for the development and update of relevant guidelines in China.The goal is to standardize and improve the specialized diagnosis and care for patients with CCD,with the ultimate aim of providing evidence-based guidance for clinical practice and improving the prognosis of patients with CCD.

关 键 词：冠心病 慢性冠状动脉疾病 心血管疾病 管理 指南解读 美国心脏协会 

分 类 号：R541.4[医药卫生—心血管疾病]