持续的腹腔动心减速和腹腔,并发症非ST段升高的急性冠状动脉综合征
Jonathan P Piccini1, Jennifer A White, Rajendra H Mehta
1Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, PO Box 17969, Durham, NC 27705, USA. jonathan.piccini@duke.edu
Circulation
|May 31, 2012
概括
持续的腹腔动脉高心率/腹腔 (VT/VF) 很少发生,但在非ST段升高的急性冠状动脉综合征 (NSTE ACS) 后晚期可能发生. 这种并发症显著增加死亡率,需要扩展监测和干预措施,以预防心律失常死亡.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 内部医学 内部医学
背景情况:
- 心室节律失常 (VT/VF) 是急性冠状动脉综合征 (ACS) 的致命并发症.
- 在非ST段升高ACS (NSTE ACS) 中持续VT/VF的发生率和预后没有得到充分描述.
- 这项研究解决了当代NSTE ACS人群中关于VT/VF的知识差距.
研究的目的:
- 为了检查持续的腹腔动心/腹腔动 (VT/VF) 的发生率.
- 在NSTE ACS患者中评估与VT/VF相关的预后和死亡率.
- 确定最佳的监测持续时间和潜在的干预措施,以防止心律失常死亡.
主要方法:
- 在NSTE ACS (EARLY ACS) 试验中早期糖蛋白IIb/IIIa抑制的9211名患者的分析.
- 检查VT/VF的累积发病率,按时间分层 (≤48小时与注册后的>48小时).
- 鉴定VT/VF的预测因素,评估30天和1年死亡率.
主要成果:
- 静脉动/静脉动的累积发病率为1.5% (n=141),其中0.6%发生在48小时内,0.9%发生在48小时后.
- 患有VT/VF的患者有更高的先前心力衰竭率,低射出分数 (<30%) 和三重血管冠状动脉疾病.
- VT/VF显著增加了30天和1年的死亡率,晚发性VT/VF (>48小时) 的风险更高.
- 在患有VT/VF的患者中,心律失常死亡的频率更高 (26.4%对6.9%).
结论:
- 持续的VT/VF在48小时后发生的可能性与NSTE ACS后的前48小时一样高.
- 与早期和晚期VT/VF相关的全因死亡率大幅增加凸显了扩大监测的必要性.
- 预防心律失常死亡的干预措施对于患有VT/VF的NSTE ACS患者至关重要.
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