患有AMI和严重降低LVEF的患者,一个明确的,仍然非常脆弱的人群 (来自AMIS Plus注册表的见解)
Marco Roberto1, André Hoepli2, Mattia Cattaneo3
1Cardiology Department, Cardiocentro Ticino, Lugano, Switzerland; Cardiology Department, Clinique Le Noirmont, Le Noirmont, Switzerland.
The American journal of cardiology
|June 22, 2023
概括
患有急性心肌梗塞 (AMI) 和严重减少左心室喷射率 (LVEF) 的患者患病率下降,但在医院死亡率仍然很高. 最佳心脏保护疗法处方仍然很低,这表明需要改进护理策略.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 公共卫生 公共卫生
背景情况:
- 左心室喷射分数 (LVEF) 是急性心肌梗塞 (AMI) 的关键预后因素.
- 有限的现实世界的数据存在于AMI患者严重减少LVEF (<30%) 的时间趋势.
研究的目的:
- 分析患有AMI和严重减少LVEF的患者患病率,治疗和治疗结果的时间趋势.
- 评估随着时间的推移,复血管化率,住院死亡率和心脏保护疗法处方的变化.
主要方法:
- 从瑞士Plus注册 (2005-2020年) 中的急性心肌梗塞中对23510名AMI患者的回顾性分析.
- 患者根据LVEF进行分类 (<30%对≥30%).
- 评估了重血管化的趋势,死亡率和最佳心脏保护疗法.
主要成果:
- 在AMI患者中,严重减少LVEF的患病率从11%降至4% (p<0.001).
- 重血管化率显著增加 (61%至84%,p<0.001),但住院死亡率仍然很高 (>20%,p=0.65).
- 出院时最佳心脏保护疗法处方率始终很低 (17%至20%).
结论:
- 患有AMI和严重降低LVEF的患者代表了一个脆弱群体,在医院内持续高的死亡率.
- 尽管复血管化增加,但治疗方面的进步并没有显著降低这一群体的死亡率.
- 准则导向心脏保护疗法的非最佳处方需要有针对性的干预措施来改善结果.
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