1. Interventional therapy is one of the effective ways to relieve symptoms in patients with chronic stable coronary heart disease with evidence of myocardial ischemia in a wide range. 2. For high-risk patients with unstable angina and non-ST-segment elevation myocardial infarction, early intervention is recommended. High-risk patients mainly include: recurrent angina pectoris or myocardial ischemia or low activity tolerance when adequate drug treatment; elevated blood myocardial enzymes; new ST-segment depression on electrocardiogram; Flow deterioration; hemodynamic instability; sustained ventricular tachycardia; interventional therapy within 6 months; coronary artery bypass grafting, etc. 3. The key to the early treatment of patients with acute ST-segment elevation myocardial infarction is to open the infarct-related vessels (IRA) to save the dying myocardium as much as possible, reduce the risk of death in the acute phase and improve the long-term prognosis. There are different strategies depending on the timing of the patient's visit and initial treatment: (1) Primary PCI: PCI directly opens IRA within 12 hours of the onset of acute myocardial infarction. Direct PCI enables timely, effective and continuous opening of IRAs. It is recommended that the "door entry-balloon opening" time be controlled within 90 minutes. Within 12 hours (especially within 3-12 hours), especially for patients with contraindications to thrombolysis, primary PCI should be performed if possible. Primary PCI is also recommended for patients with ischemic symptoms, cardiac dysfunction, hemodynamic instability, or severe arrhythmias who have been onset for more than 12 hours. For patients with cardiogenic shock, the time can be relaxed to 36 hours. For patients with onset more than 12 hours and no ischemic symptoms, PCI is not recommended. (2) Transfer PCI: The first-visited hospital does not have the conditions for primary PCI, and the patient cannot immediately undergo thrombolysis, so the patient should be transferred to a hospital with PCI conditions for primary PCI. (3) Remedial PCI: The IRA is still in the occluded state after the failure of thrombolysis, and the PCI performed for the IRA is performed. (4) Facilitated PCI: Within 12 hours of onset, patients who are going to undergo PCI plan to use thrombolytic or antiplatelet drugs in advance before PCI, so as to open IRA as soon as possible.




