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您的检索式：作者名="Alexander D Simms"
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| 1 | Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention显示文摘Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction(NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention(PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed. | Richard A Brogan Christopher J Malkin Philip D Batin Alexander D Simms James M McLenachan Christopher P Gale | 2014 | World Journal of Cardiology2014，6，8： | 6 |
| 2 | Acute coronary syndromes: an old age problem显示文摘在老年的增加的人口将导致他们的更大的数字与急性冠的症候群(交流) 介绍。这在全球保健资源上有含意并且为基于证据的治疗要求更好的管理和选择。老比更年轻的交流是有更重要的治疗好处的一个高风险组。不过,在交流的相关不平等在乎的年龄被认出并且坚持。到某程度,在照顾的这差异被不正常、推迟的演讲的更高的频率在表示在老、不太诊断的心电图解释,加强在交流的延期诊断。在死亡风险在的评价下面由于为生理的脆弱,合作病态,认知 / 心理的缺陷和物理残疾的有限考虑老,由心病学专家和 randomised 的缺乏的更少的输入,指导管理在的控制试用数据老可以进一步使照顾的不平等惊讶。当这些不平等存在时,在那里仍然是一个实质的机会改进年龄相关交流结果。为特定的治疗和药政体的老病人的选择是未答复的。对 randomised 有成长需要,人口更代表性并且与合作病态先进年龄注册那些的控制试用数据。不利事件报导的缺乏,张贴冠的 angiography 例如肾的缺陷,在老进一步的限制风险利益决定。在老交流病人的照顾的实质的改进被要求并且应该被倡导。最终,这些改进是可能的导致更好的结果柱子交流。然而,在结果的改进不是无限的并且将由年龄相关的风险的非可修改的因素有限。 | Alexander D Simms Philip D Batin John Kurian Nigel Durham Christopher P Gale | 2012 | Journal of Geriatric Cardiology2012，9，2： | 3 |
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