急性心筋梗塞の後,静かなイシュケミアの発生率が増加しています
G J Taylor1, R E Katholi, K Womack
1Prairie Cardiovascular Center, Springfield, Ill.
JAMA
|September 16, 1992
まとめ
心筋梗塞に対する血栓駆除療法を受けている患者は,既存の心筋梗塞を持つ患者と比較して,誘発性性性硬血症の際に, signicantly fewer angina を経験しました. これは,血栓溶解後に静かなイシュケミアが一般的であることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 介入性心臓病学 介入性心臓病学
- 心筋梗塞の研究
背景:
- 胸痛は,心筋不全の特徴的な症状である.
- 血栓駆除薬療法は,急性心筋梗塞 (AMI) の重要な治療法である.
- AMIと血栓溶解後のイシュケミアの存在と重症度は,さらなる調査を必要とします.
研究 の 目的:
- 誘発性心筋動脈不全の時に発症する胸痛の発生率を比較する.
- AMIのための血栓解消療法で治療された患者と,以前に存在していた胸の痛みを持つ患者との比較を評価する.
- 血栓解剖後の血栓不全反応と心筋活性を評価する.
主な方法:
- 比較研究は,高級心臓病リファールセンターで行われました.
- アンギナ・ペクトリスの25人の患者と,AMIのトランスルミナル冠動脈血管新生手術 (PTCA) を受けたAMIのトランスルミナル冠動脈血管新生治療の2日後の30人の患者は,皮膚経由の冠動脈血管新生手術を受けた.
- 冠動脈閉塞はPTCA中に気球の膨張を使用して5分間誘発され,心電図と肺動脈の圧による評価が行われました.
主要な成果:
- 胸痛は,風船閉塞中に胸痛グループで64% (16/25) の患者に発症した.
- 対照的に,血栓溶解群の患者の30% (9/30) だけが,心臓発作動脈の閉塞 (P < .01) 時に心痛を報告した.
- イシュケミアに対する心電図反応と肺圧の変化は,2つのグループ間で比較可能であった.
結論:
- 心筋梗塞のために血栓駆除療法を受けている患者は,誘発性イシュケミア中にアンギナの発生率が低いことを示しています.
- 静かな心筋動脈不全症は,AMIの血栓解離療法を受けた患者の間で一般的であることが判明しています.
- これらの発見は,トランボリシス後の期間に認識されていない不血症イベントの可能性を強調しています.
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