一个区域系统,为ST升高心肌梗塞提供及时获得穿皮冠状动脉干预的机会
Timothy D Henry1, Scott W Sharkey, M Nicholas Burke
1Minneapolis Heart Institute Foundation, 920 E 28th St, Ste 40, Minneapolis, MN 55407, USA. henry003@umn.edu
Circulation
|August 4, 2007
概括
快速将ST升高心肌梗塞 (STEMI) 患者转移到皮肤冠状动脉干预 (PCI) 中心是安全的,也是可行的. 一个标准化的系统为STEMI患者提供了及时的PCI,即使是从远方医院转移的患者.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 紧急医疗 紧急医疗
背景情况:
- 穿皮冠状动脉干预 (PCI) 在ST升高心肌梗塞 (STEMI) 时优于纤维解析.
- 欧洲试验表明,PCI转移改善了结果和访问,但美国的转移时间往往很长.
- 这挑战了在美国转移PCI战略的实用性.
研究的目的:
- 评估基于PCI的标准化治疗系统对STEMI患者的可行性和安全性.
- 为了评估从210英里外的医院转移的STEMI患者的门到气球时间.
- 通过转移协议治疗高风险STEMI人群的结果.
主要方法:
- 开发了一个基于PCI的标准化治疗系统,用于30家离PCI中心210英里范围内的医院.
- 连续治疗了1345名STEMI患者 (2003年3月至2006年11月),其中包括1048个转移.
- 测量不同转移区 (<60英里和60-210英里) 的患者的门到气球的时间.
主要成果:
- 门到气球的平均时间为95分钟60英里以下,120分钟60-210英里.
- 该研究包括高风险人群:12.3%的心脏性休克,10.8%的心脏骤停,14.6%的老年人 (>80岁).
- 住院死亡率为4.2%,住院时间中位数为3天.
结论:
- 对于STEMI患者来说,快速转移系统是安全和可行的.
- 标准化协议使STEMI患者从距离210英里远的社区医院转移到有效的PCI.
- 这种综合转移系统可以改善STEMI患者及时获得PCI的机会.
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