在心肌梗塞II研究中,在血栓溶解过程中进行的冠状动脉血管造形术
Circulation
|January 1, 1992
概括
经过复合组织类型等离子体激活剂的皮肤透光冠状动脉血管塑造显示出良好的结果,但某些患者群体面临更高的风险,例如再发病或死亡等不良结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血栓溶解疗法 血栓溶解疗法
背景情况:
- 相当数量的心肌梗塞患者在血栓治疗后接受皮肤透光冠状动脉血管造形术 (PTCA).
- 心肌梗塞中血栓溶解 (TIMI) II研究提供了在复合组织类型血原激活剂 (rt-PA) 后PTCA结果的数据.
研究的目的:
- 评估皮肤透光冠状动脉血管造形术 (PTCA) 的结果,该术是在肌肉梗塞患者接受重组组织类型等离子体激活剂 (rt-PA) 后进行的.
- 在这个患者队列中,确定与PTCA后不良结果相关的临床和解剖因素.
主要方法:
- 在TIMI II研究中,分析了TIMI II研究中的1,414名接受PTCA在rt-PA给药后42天内接受PTCA患者的数据.
- 多变量分析以根据患者特征和程序时间来确定不良事件的风险比率.
主要成果:
- 在88.7%的患者中,实现了初级血管学成功.
- 在1年内发生的不良结果 (死亡,心脏复发,进一步复血管) 发生在25.1%的患者中.
- 在rt-PA后2小时内接受治疗的患者和70岁以上的患者中,发现PTCA失败的风险增加.
- 多血管疾病和先前心痛与重血管化的风险增加以及死亡率/复发性心脏病发作的风险有关.
结论:
- 在心肌梗塞中使用rt-PA之后的PTCA通常具有有利的结果,但存在风险.
- 特定的患者亚组,包括患有多血管疾病,先前心痛,年龄较大和早期PTCA时间的患者,风险更高.
- 这些发现是评估肌肉梗塞患者PTCA结果的基准,患者接受了血栓溶解治疗.
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