在具有多血管或未受保护的左主疾病的稳定患者中进行特设皮肤穿透冠状动脉干预
Edward L Hannan1, Ye Zhong1, Kimberly Cozzens1
1University at Albany, State University of New York, Albany, New York, USA.
JACC. Cardiovascular interventions
|July 26, 2023
概括
临时穿皮冠状动脉干预 (PCI) 经常用于多血管 (MV) 或左主 (LM) 疾病患者. 医院存在广泛的差异,这表明需要标准化的心脏团队方法.
科学领域:
- 心血管干预 心血管干预
- 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:
- 关于在稳定的多血管 (MV) 或未受保护的左主 (LM) 疾病中使用临时皮肤穿透冠状动脉干预 (PCI) 的数据有限.
- 对于这些复杂的患者群体,建议采用心脏团队方法.
研究的目的:
- 确定在患有MV或LM疾病的患者中临时PCI的利用率.
- 调查这些患者群体的临时PCI实践中医院间的变化.
主要方法:
- 利用了纽约州心脏病登记处2018-2019年的数据.
- 分析了临时PCI作为所有PCI和MV/LM疾病的再血管化的百分比.
主要成果:
- 78.4%的符合条件的患者进行了临时PCI,病情因疾病复杂性而异 (58.7%的不受保护的LM到85.4%的2血管近端LAD疾病).
- 临时PCI代表了所有重血管化的35.1%,显示出医院水平的显著变化 (15%至46%为三血管疾病).
- 在没有现场手术的医院和特定患者子组中,利用率更高.
结论:
- 临时PCI在MV/LM疾病中很常见,特别是在2血管近位LAD疾病中.
- 在医院和患者因子 (糖尿病,低射出分数) 之间,临时PCI使用的显著差异值得注意.
- 建议所有医院采用系统方法来标准化心脏团队咨询和共享决策.
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