穿皮冠状动脉干预后急性功能衰竭的发生率和预后重要性
Charanjit S Rihal1, Stephen C Textor, Diane E Grill
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Circulation
|May 16, 2002
概括
穿皮冠状动脉干预 (PCI) 后的急性功能衰竭 (ARF) 是不常见的,但显著增加死亡率. 糖尿病患者的基线肌素<2.0 mg/dL和所有基线肌素>2.0 mg/dL的患者面临更高的ARF风险.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 干预心脏病学 干预心脏病学
背景情况:
- 在当代实践中,穿皮冠状动脉干预 (PCI) 后急性功能衰竭 (ARF) 的发生率和预后影响仍然不清楚.
- 了解ARF风险对于患者管理和PCI后的结果至关重要.
研究的目的:
- 确定PCI后ARF的发病率,风险因素和预后影响.
- 确定患有ARF风险较高的患者子组.
主要方法:
- 梅奥诊所PCI注册表的回顾性分析.
- 包括接受PCI的7586名患者.
- 对ARF的定义是血清肌素>0.5 mg/dL比基线的增加.
主要成果:
- 在3.3%的患者 (254/7586) 中发生了ARF.
- 风险因素包括基线血清肌素,急性心肌梗塞,休克和对比度体积.
- 糖尿病患者的基线肌素<2.0 mg/dL具有更高的ARF风险;所有基线肌素>2.0 mg/dL的患者都有高风险.
- ARF与显著增加的住院 (22%对1.4%) 和长期死亡率 (1年:12.1%对3.7%;5年:44.6%对14.5%) 相关.
结论:
- 在PCI后ARF的总体发病率很低.
- 特定的患者群体,包括糖尿病患者的基线肌素<2.0 mg/dL和所有基线肌素>2.0 mg/dL,都存在高风险.
- ARF是住院和长期随访期间死亡率的强有力的预测因素.
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