在选择性皮肤冠状动脉干预后不久的冠状动脉内ST细分移动准确地预测了周围手术心肌损伤
Vruyr Balian1, Michele Galli, Claudio Marcassa
1Cardiologia Interventistica, Azienda Ospedaliera di Busto Arsizio, Varese, Italy. vbalian@aobusto.it
Circulation
|October 25, 2006
概括
内冠状动脉ST段监测可以在皮肤冠状动脉干预 (PCI) 后快速识别心肌损伤,即使是在成功的程序后. 这种方法有助于检测可能需要进一步治疗和延长住院的患者.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物标志物研究 生物标志物研究
背景情况:
- 皮肤穿刺冠状动脉干预 (PCI) 后心脏生物标志物升高表明心肌损伤,并预测不良事件.
- 尽管PCI成功,但评估周围手术心肌损伤对于患者的治疗结果至关重要.
研究的目的:
- 评估使用导线记录冠状动脉ST段的有效性,以快速识别PCI后心肌损伤.
- 为了确定冠状动脉内ST段的转移是否与I型托波宁水平相关,并预测心脏不良事件.
主要方法:
- 108名接受可选单血管PCI的患者在手术前后通过导线记录了冠心电图.
- 心肌损伤的定义是托波I的增加;冠状动脉内ST段转移>或=1毫米被认为是显著的.
- 收集了主要冠状动脉事件的长期随访数据.
主要成果:
- 46%的患者患有心肌损伤,但只有10%的患者有异常的肌酸激酶-MB.
- 在PCI后的冠状动脉内ST段转移确定了93%的心肌损伤患者,灵敏度为74%和特异性为95%.
- ST段转移是心肌损伤的唯一独立预测因素 (OR 54.1,P<0.0001).
结论:
- 内冠状动脉ST段转移有效地识别PCI后心肌损伤,即使在成功干预后.
- 这种技术提供了一个快速,廉价的方法来检测需要潜在的辅助治疗或更长时间住院的患者.
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