在慢性全闭性冠状动脉外皮干预期间使用皮革机械支的全国趋势
Yasser Al-Khadra1, Mohsin Salih1, Mohammad Al-Akchar1
1Cardiovascular Division, Southern Illinois University School of Medicine, Springfield, Illinois.
The American journal of cardiology
|June 30, 2023
概括
机械循环支持 (MCS) 在冠状动脉慢性全封闭 (CTO) 的皮革冠状动脉干预 (PCI) 中的使用显著增加. 女性性别和功能衰竭与这些手术中较高的死亡风险有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 冠状动脉慢性全封闭 (CTO) 在患有多血管冠状动脉疾病的患者中很普遍.
- 穿皮冠状动脉干预 (PCI) 为CTO提供了有利的结果,但机械循环支持 (MCS) 使用数据有限.
- 调查CTO PCI中MCS趋势和并发症对于了解患者管理至关重要.
研究的目的:
- 分析冠状动脉慢性全封闭 (CTO) 的皮肤冠状动脉干预 (PCI) 期间机械循环支持 (MCS) 使用趋势.
- 在CTO PCI中评估与MCS使用相关的周围程序并发症.
- 确定MCS患者接受CTO PCI的患者死亡率的预测因素.
主要方法:
- 利用国家住院患者样本数据库 (2011-2019) 来识别接受PCI的CTO患者.
- 应用了Cochran-Armitage方法来评估MCS利用的线性趋势.
- 采用多变量逻辑回归来确定死亡率的独立预测因素.
主要成果:
- 观察到CTO PCI的MCS利用有显著的线性上升趋势,从2011年的1.4%增加到2019年的7.0%.
- 接受MCS治疗的患者年龄较大,并具有更高的并发症负担.
- 女性性别,功能衰竭,滥用酒精,凝血病和液体/电解质疾病预测了MCS组的死亡率.
结论:
- 机械循环支持 (MCS) 在冠状动脉慢性全封闭 (CTO) 穿皮冠状动脉干预 (PCI) 中的使用正在增加.
- 女性性别和功能衰竭是MCS支持的CTO PCI手术中死亡率增加的独立预测因素.
- 需要进一步的研究来优化CTO PCI中MCS的患者选择和管理策略.
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