急性下心筋梗塞時の鉛V1ST上昇の予後値
Cheuk-Kit Wong1, Wanzhen Gao, Ralph A Stewart
1Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Circulation
|July 21, 2010
まとめ
急性下心筋梗塞の際に,鉛VのST上昇は,特に持続すると,より高い死亡リスクを示します. この発見は,よりよい管理のために,高リスクの患者を特定するのに役立ちます.
科学分野:
- 心臓病学 心臓病学
- エレクトロカーディオグラフィーです.
- 心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは心筋梗塞 (Myocardial Infarction) とは
背景:
- リードV ((1) 急性下心筋梗塞 (MI) でのST上昇は,右心室関節または前側側心筋梗塞の関与を示唆する可能性があります.
- V(1) ST上昇の予後的意義は,同時に起こる V(3) ST変化に依存する可能性があります.
研究 の 目的:
- 急性下心筋梗塞の際に,鉛VのST上昇の予後的意義を調査する.
- V(1) STの上昇がV(3) STの変化を考慮して30日間の死亡率を予測するかどうかを判断する.
主な方法:
- HERO-2試験の7967人の急性下位MI患者の分析.
- ベースラインとフィブリノリシス後の測定を含む,V(1) とV(3) のSTレベルの電動心臓分析.
- 30日間の死亡率を予測するためのV(3) STレベル,下側ST上昇,および臨床的要因の統計的調整.
主要な成果:
- ベースラインV(1) 連続変数としてのST上昇は,30日間の死亡率の増加と関連していました (調整後のオッズ比1.24).
- Vの0.5mmの上昇は,STの上昇と死亡率の25%の上昇と相関していた.
- 持続的なV(1) ST上昇 (≥1mm) 線維分解後60分は,著しく高い死亡率 (10.8%対5.5%) と関連していました.
結論:
- 鉛VのST上昇は,急性下心筋梗塞におけるより高い死亡率の独立した予測因子である.
- このECGの発見は,より密接なモニタリングと管理を必要とする高リスクの患者を特定するのに役立ちます.
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