在接受复杂或非复杂的皮肤冠状动脉干预的患者中进行外置心肌梗塞
Raffaele Piccolo1, Attilio Leone1, Fiorenzo Simonetti1
1Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
概括
复杂的穿皮冠状动脉干预 (PCI) 与非复杂的PCI相比,显著增加了周围手术性心肌梗塞 (MI) 的风险. 仔细的程序规划对于管理慢性冠状动脉综合征患者这种高风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床研究 临床研究
背景情况:
- 关于复杂与非复杂的皮肤冠状动脉干预 (PCI) 中周围手术心肌梗塞 (MI) 风险的数据有限.
- 评估这种风险对于患者安全和程序规划至关重要.
研究的目的:
- 评估在接受复杂或非复杂选择性PCI的患者中围手术性MI的风险.
- 使用多个诊断标准比较MI率,包括第四个心肌梗塞普遍定义 (UDMI).
主要方法:
- 未来的,单中心注册表研究.
- 包括1010名患有慢性冠状动脉综合征的患者,他们在2017年至2021年期间接受了选择性PCI.
- 根据多个标准 (例如,治疗了≥3个血管,植入了≥3个支架,治疗了慢性全闭症) 定义复杂的PCI.
主要成果:
- 复杂的PCI在22.4%的患者中进行 (226/1010).
- 在复杂的PCI患者中,在多个定义中,周围手术性MI的发病率显著更高 (例如,在第四次UDMI时,26.5%与14.5%相比;p < 0.001).
- 复杂的PCI独立预测了第四次UDMI周围手术性MI (OR1.54,95%CI:1.04-2.27,p=0.031).
结论:
- 复杂的PCI与可选PCI患者的围手术性MI风险显著增加有关.
- 这些发现强调了需要事先考虑与复杂的PCI程序相关的高风险.
- 风险分层和仔细规划对于接受复杂PCI的患者至关重要.
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