接受ST升高和非ST升高心肌梗塞心脏导管治疗的患者的长期死亡率
Mark Y Chan1, Jie L Sun, L Kristin Newby
1MBBS, MHS, National University Heart Center, 5 Lower Kent Ridge Road, Singapore, Singapore 119074. chanyymark@gmail.com
Circulation
|June 10, 2009
概括
ST段升高心肌梗塞 (STEMI) 携带更高的短期死亡风险,而非STEMI (NSTEMI) 则具有更高的长期死亡风险. 早期的再血管化改善了STEMI和NSTEMI患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床结果研究研究
背景情况:
- 现有有限的当代数据比较了ST段升高心肌梗塞 (STEMI) 和非STEMI (NSTEMI) 心脏导管治疗后的长期结果.
- 了解干预措施的差异性风险和益处对于急性心肌梗塞 (AMI) 管理至关重要.
研究的目的:
- 为了比较进行心脏导管治疗的STEMI和NSTEMI患者之间的长期死亡率.
- 为了评估早期再血管化的对STEMI患者死亡率的影响,与NSTEMI患者对比.
主要方法:
- 对4387名患有显著冠状动脉病变的患者进行了回顾性分析,这些患者接受了心脏导管治疗 (1999-2005).
- 经过时间调整的死亡率的比较,使用碎片分析.
- 在STEMI和NSTEMI队列中对早期再血管化的对死亡率影响的分层分析.
主要成果:
- 与NSTEMI患者相比,STEMI患者的短期死亡风险 (前2个月) 调整较高.
- 2个月后,NSTEMI患者的长期死亡风险调整较低.
- 在STEMI和NSTEMI组中,早期的再血管化与调整后的死亡风险降低有关,没有显著的相互作用.
结论:
- STEMI与更高的短期死亡率有关,而NSTEMI与冠状动脉疾病急性心脏病患者的长期死亡率增加有关.
- 早期的再血管化为STEMI和NSTEMI提供了可比的长期生存益处.
- 建议在临床试验中进行延长的随访,以调查NSTEMI中的早期再血管化,以检测治疗的益处.
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