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Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix
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初级血管整形与急性心肌梗塞的医院前纤维解:一项随机化研究

Eric Bonnefoy1, Frédéric Lapostolle, Alain Leizorovicz

  • 1Coronary Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France.

Lancet (London, England)
|September 24, 2002
PubMed
概括

初级血管造形术在急性心肌梗塞治疗中并不优于医院前纤维解析. 这两种策略在30天后显示了死亡,心脏复发和致残性中风的类似结果.

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科学领域:

  • 心脏病学 心脏病学
  • 紧急医疗 紧急医疗
  • 临床试验 临床试验

背景情况:

  • 医院前纤维解析和初级血管塑造对急性心肌梗塞 (AMI) 有好处.
  • 这两种AMI治疗方法之间缺乏直接比较.
  • 这项研究旨在比较AMI的初级血管造形与医院前纤维素分解.

研究的目的:

  • 为了确定初级血管整形在治疗急性心肌梗塞方面是否优于医院前纤维解析.
  • 为了比较这两种早期再输血策略的疗效和安全性.

主要方法:

  • 一个随机的多中心试验,涉及840名ST段升高心肌梗塞患者,症状发作6小时内.
  • 患者被分配到医院前纤维解析 (alteplase) 或初级血管塑造.
  • 主要终点是30天死亡,非致命的复发性心脏病发作和非致命的致残性中风的组合,根据治疗意图进行分析.

主要成果:

  • 与初级血管造形术 (190分钟) 相比,医院前纤维解 (130分钟) 的中位治疗延迟更短.
  • 主要终点发生在8.2%的医院前纤维化解组和6.2%的初级血管塑性组 (不具有统计学意义).
  • 死亡率相似:纤维解析为3.8%,血管塑造为4.8%.

结论:

  • 在患有早期急性心肌梗塞的患者中,初级血管整形没有被发现优于医院前纤维解析.
  • 这两种策略,当随后转移到干预设施以进行可能的救援血管造形手术时,提供了可比的临床益处.