軽微な心筋損傷と予後:自発的および皮膚経由の冠動脈介入に関連するイベントは異なりますか?
K Martijn Akkerhuis1, John H Alexander, Barbara E Tardiff
1Thoraxcenter, University Hospital Rotterdam, The Netherlands. k.makkerhuis@freeler.nl
Circulation
|February 6, 2002
まとめ
経皮冠動脈干渉 (PCI) の後のクレアチンキナーゼ-MB (CK-MB) 値上昇の予後効果は,急性冠動脈症候群 (ACS) の自発性心筋縮の予後効果に類似しています. 高いCK-MBレベルは,両方のシナリオで6ヶ月の死亡率の増加と相関しています.
科学分野:
- 心臓病学 心臓病学
- バイオマーカー バイオマーカー
- クリニック・トライアル 臨床試験
背景:
- 経皮冠動脈干渉 (PCI) の後のクレアチンキナーゼ-MB (CK-MB) の上昇の予後的意義は議論されている.
- この研究では,PCI後のCK-MB上昇を,急性冠動脈症候群 (ACS) の自発的なCK-MB上昇と比較した.
研究 の 目的:
- ACS患者におけるPCI後のCK-MB上昇と自発的なCK-MB上昇の予後効果を比較する.
- 両グループにおけるCK-MBレベルと6ヶ月の死亡率との関係を評価する.
主な方法:
- 医学的に治療されたACS患者に対するPURSUIT試験のデータの分析.
- PCIを受けている患者を対象とした5つの臨床試験の統合分析.
- CK-MBレベル (正常値の上限までの比率) に基づく6ヶ月の死亡率の比較.
主要な成果:
- PCI/CABGのない非ST上昇ACS患者では,より高いCK-MBレベルで6ヶ月の死亡率は増加しました.
- PCI患者では,処置後のCK-MBレベルと6ヶ月の死亡率との間には比例した関係が観察されました.
- CK-MBの上昇による死亡率の相対的な増加は,PCIに関連したおよび自発的な心筋縮症でも同様でした.
結論:
- 臨時手術による心筋縮の不良予後の影響は,自発的な心筋縮に匹敵する.
- CK-MBの上昇は,その原因 (手続的対自発的) にかかわらず,同様の予後マーカーとして機能します.
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