彰基急診醫學部蔡天賜 醫師Unstable, troubleStablePathophysiologyThrombinAGGREGATIONFibrinHemostaticclotClottingPlatelet Aggregation0 min 10 min5 minSECONDARYPRIMARYCOAGULATION活化凝血系統 活化凝血酵素 (thrombin)不穩定粥狀斑塊破裂，導致血小板凝集與活化纖維蛋白在血小板之間連結，產生血栓藥物 Antiangina or anti-ischemia Morphine, oxygen, NTG, B-blockers Antiplatelet Aspirin GP IIb/IIIa inhibitors ADP inhibitors - Clopidogrel Antithrombin Unfractionated Heparin Low molecular-weight heparin Fibrinolytics TPASTEMI NSTEMIAMI 病患死亡時間52%19%8%21%到院前死因與心律不整 (VF)有關，大部份發生於前 4個小時
