選択的な皮膚経冠動脈介入の直後の冠内STセグメントシフトは,周辺の手続き性心筋損傷を正確に予測します
Vruyr Balian1, Michele Galli, Claudio Marcassa
1Cardiologia Interventistica, Azienda Ospedaliera di Busto Arsizio, Varese, Italy. vbalian@aobusto.it
Circulation
|October 25, 2006
まとめ
冠内STセグメントのモニタリングは,経皮冠動脈干渉 (PCI) の後に,成功した手順の後にさえも,心筋損傷を迅速に特定することができます. この方法は,さらなる治療と長期の入院を必要とするかもしれない患者を検出するのに役立ちます.
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
- バイオマーカーの研究
背景:
- パーキュタヌス冠動脈介入 (PCI) の後の心臓バイオマーカーの上昇は,心筋損傷を示し,有害事象を予測します.
- 成功したPCIにもかかわらず,心筋回路損傷の評価は,患者のアウトカムにとって極めて重要です.
研究 の 目的:
- 冠動脈内STセグメント記録の有効性を評価するために,PCI後の心筋損傷の迅速な識別のためのガイドワイヤを使用します.
- 冠内STセグメントのシフトがトロポニンIレベルと相関し,不良心事象を予測するかどうかを判断する.
主な方法:
- 選択型単血管PCIを受けた108人の患者は,手術前と後にガイドワイヤーで冠内心電図を記録した.
- 心筋損傷はトロポニンIの増加によって定義され,冠内STセグメントのシフト>または=1mmは有意とみなされた.
- 主要冠動脈イベントに関する長期フォローアップデータを収集した.
主要な成果:
- 患者の46%に心筋損傷がみられたが,異常なクレアチンキナーゼ-MB.を患ったのは10%のみであった.
- PCI後の冠内STセグメントシフトは,心筋損傷の患者の93%を特定し,74%の感度と95%の特異性を示しました.
- STセグメントシフトは,心筋損傷の唯一の独立した予測因子 (OR 54.1,P<0.0001) でした.
結論:
- 冠内STセグメントシフトは,PCI後の心筋損傷を,成功した介入後でも効果的に特定します.
- このテクニックは,潜在的な補助療法または長期の入院を必要とする患者を検出するための迅速で安価な方法を提供します.
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