高灵敏性心脏热在表现上排除心肌梗塞:一个渐进的边缘集群随机对照试验
Atul Anand1, Kuan Ken Lee1, Andrew R Chapman1
1BHF Centre for Cardiovascular Science (A.A., K.K.L., A.R.C., A.V.F., P.D.A., F.E.S., K.A.A.F., D.E.N., A.S.V.S., N.L.M.), University of Edinburgh, United Kingdom.s.
通过使用高灵敏度的素测定,早期排除心肌梗塞的途径显著减少了住院和入院时间. 虽然没有达到30天的安全性,但在1年内心脏病事件没有增加.
科学领域:
- 心脏病学
- 紧急医疗
- 临床试验
背景情况:
- 高灵敏度的心脏素测试可以更早地排除心肌梗塞.
- 早期排除策略的安全性和有效性仍然不确定.
- 研究了急性冠状动脉综合征患者的早期排除途径.
研究的目的:
- 确定疑似急性冠状动脉综合征患者心肌梗塞早期排除途径的安全性和有效性.
- 评估对停留时间和30天安全结果 (心肌梗塞或心脏死亡) 的影响.
主要方法:
- 在7个苏格兰医院进行随机对照试验.
- 包括31,492名疑似患有急性冠状动脉综合征的患者.
- 主要结局:停留时间和30天的安全性;安全性和次要结局的1年随访.
主要成果:
- 住院时间从10. 1小时减少到6. 8小时;出院患者比例从50%增加到71%.
- 没有证明30天的安全性非劣势 (P=0. 068),但观察到的差异有利于早期排除途径 (0. 4% vs 0. 3%).
- 一年后,心脏事件,重返医院或全因死亡率没有显著差异.
结论:
- 早期排除心肌梗塞的途径减少了住院时间和住院时间.
- 尽管没有达到30天的安全性非劣势,但在1年内心脏事件没有增加.
- 采用这种途径为患者和医疗保健提供者提供了显著的好处.
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