患有急性缺血综合征的患者有或没有ST段升高的心脏性休克
D R Holmes1, P B Berger, J S Hochman
1Mayo Clinic and Foundation, Rochester, MN 55905, USA. dholmes@mayo.edu
Circulation
|November 16, 1999
概括
在急性缺血综合征中,即使没有ST段升高,心脏性休克也可能发生. 虽然发病率和患者概况不同,但ST升高和非ST升高的心肌梗塞患者的死亡率仍然很高,他们经历了冲击.
科学领域:
- 心脏病学 心脏病学
- 急性冠状动脉综合征是什么
- 心肌梗塞的心脏病发作
背景情况:
- 心脏性休克通常与ST段升高心肌梗塞有关.
- 关于非ST段升高心肌梗塞 (NSTEMI) 的冲击发生率和结果的数据有限.
- 全球使用策略打开封闭的冠状动脉 (GUSTO) -IIb试验提供了一个大数据集来调查这一点.
研究的目的:
- 确定有或没有ST段升高的患者心脏性休克的发生率和结果.
- 为了比较这两个群体之间的心血管性休克的特征,时间,临床过程和血管学发现.
主要方法:
- 分析了来自GUSTO-IIb试验的12,084名患者,这些患者最初没有出现心脏性休克.
- 基于在入学电心图 (ECG) 上的ST段升高的患者分类.
- 在ST-elevation和非ST-elevation组之间比较冲击发生率,发育时间,基线特征和死亡率.
主要成果:
- 心脏性休克发生在ST升高患者的4.2%,而非ST升高患者的2.5% (OR0.581,P<0.001).
- 在没有ST升高的患者中,冲击发生较晚,这些患者年龄较大,患有更多的糖尿病和三血管疾病,但TIMI级0流量较少.
- 两组患者的死亡率都很高:ST升高患者为63%,非ST升高患者为73%.
结论:
- 心脏性休克是急性缺血综合征的重要并发症,无论ST段的升高.
- 在ST升高和非ST升高心脏病性休克之间存在明显的发病率,患者资料,时间和血管学发现的差异.
- 心脏性休克的死亡率在ST升高和非ST升高心肌梗塞中相对较高.
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