冠動脈手術によって引き起こされた非血行性胸痛:冠動脈血管形成術とステントインプラントを比較した前向きな研究
A Jeremias1, S Kutscher, M Haude
1Department of Cardiology, and Psychosomatic Medicine, University Hospital Essen, Germany. jermias@stanford.edu
Circulation
|December 16, 1998
まとめ
ステント移植後の胸痛は一般的であり,血管の過剰膨張が原因で起こる可能性が高い. この"ストレッチの痛み"は,ステントを施す患者のほぼ半分に影響します.
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
- 血管医学 血管医学とは
背景:
- 胸痛は,冠動脈手術後の一般的な症状であり,しばしば24時間以内に不血症の兆候がない.
- ある仮説によると,この痛みは"ストレッチ・ペイン"と呼ばれる局所的な血管損傷によるものです.
研究 の 目的:
- 経皮透光冠動脈血管形成術 (PTCA),ステント移植,および診断冠動脈血管撮影後の胸痛の原因を調査するために.
- 冠動脈手術を受ける患者の"ストレッチ疼痛"仮説を検証する.
主な方法:
- 冠動脈血管造影,PTCA,またはステント植入を施した145人の患者を対象とした前向きな研究.
- 手術後の24時間以内に胸の痛みを定量化するための検証されたアンケート.
- 12リードEKGと心臓イソ酵素は,心筋不全の検出に使用されます.
主要な成果:
- 胸痛は,ステント患者41.2%,PTCA患者12.1%,血管撮影のみの患者9.8% (P<0.001) で発生しました.
- 胸の痛みを報告した患者の9.7%だけが,前回のアンギナに類似していると報告しました.
- ステントインプラントは,PTCA (3.14対1.95mm) と比較して,より大きな最小ルメン直径をもたらしました.
- 重要なEKGの変化は認められませんでしたが,3人のステント患者では心臓のイソ酵素が上昇していました.
結論:
- 非乳房性胸痛は,ステント移植後の患者のほぼ半数の間で一般的です.
- この痛みは,病んだ冠動脈のセグメント内のステントによって引き起こされる血管の過剰膨張に関連しているようです.
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