在老年患有心肌梗塞的老年患者中进行完整或仅为罪祸首的PCI
Simone Biscaglia1, Vincenzo Guiducci1, Javier Escaned1
1From the Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara (S.B., V. Lodolini, R.P., P.C., C.T., A.E., C.P., G. Campo), the Cardiology Unit, Azienda Unità Sanitaria Locale (USL) IRCCS Reggio Emilia, S. Maria Nuova Hospital, Reggio Emilia (V.G., G.P.), the Cardiology Unit, Ospedale Maggiore (V. Lanzilotti, G. Casella, G.I.), and the Department of Biomedical and Neuromotor Sciences, University of Bologna (E.M.), Bologna, the Cardiovascular Department, Infermi Hospital, Rimini (A.S., M.M.), the Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, and Rivoli Infermi Hospital ASL TO3, Turin (E.C., F.V.), the Cardiology Unit, Umberto I Hospital, ASP Siracusa, Siracusa (G.S.), S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia (A.M., G. Caretta), the Cardiology Unit, Ospedale Civile di Baggiovara, Baggiovara (M.R.), Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, Venice (M.B.), the Department of Cardiology, S. Maria delle Croci Hospital, Ravenna (L.F.), the Cardiovascular Department, Azienda USL Toscana Sud-Est, Misericordia Hospital, Grosseto (A.P.), the Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome (G.B.-Z.), and the Cardiology Unit, Ospedale Santa Maria Goretti, Latina (I.C.), Mediterranea Cardiocentro, Naples (G.B.-Z.), Maria Cecilia Hospital, Cotignola (P.C., D.D.), the Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome (E.B.), and the Interventional Cardiology Unit, Presidio Ospedaliero San Salvatore di Pesaro, Pesaro (M.T.) - all in Italy; Hospital Clínico San Carlos, Complutense University of Madrid (J.E.), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), and Instituto de Investigación Hospital La Paz, University Hospital La Paz (R.M., A.J.-R.), Madrid, CIBERCV, Department of Cardiology, Hospital Clínico Universitario, Valladolid (I.A.S.), and CIBERCV, Cardiology Department, H. Universitario y Politécnico La Fe, Valencia (J.L.D.G.) - all in Spain; and the Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland (D.D.).
在老年患有心肌梗塞和多血管疾病的老年患者中,完整的重血管化显著减少了主要不良事件. 在这个人群中,生理学引导的完整重血管化优于罪祸首损伤的皮肤冠状动脉干预 (PCI).
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 老年心脏病学 老年心脏病学
背景情况:
- 对于患有心肌梗塞和多血管疾病的老年患者 (≥75岁) 的最佳治疗策略尚未确立.
- 在这个人口群体中,完整的复血管化效益仍然不清楚.
研究的目的:
- 在老年患有心肌梗塞和多血管疾病的老年患者中,比较生理学引导的完整重血管化的疗效和安全性与罪祸首损伤单纯的皮肤冠状动脉干预 (PCI).
主要方法:
- 一个多中心随机试验,涉及1445名心肌梗塞和多血管疾病的PCI患者 (平均年龄80岁).
- 患者被分配到非罪祸首损伤的生理学导向完全重血管化或罪祸首损伤的PCI.
- 主要结局:死亡,心肌梗塞,中风或1年后再血管化的综合结局. 二次结局:心血管死亡或心肌梗塞.
主要成果:
- 完全重血管化组 (720名患者) 的初级结局率 (15.7%) 与罪祸首组 (725名患者,21.0%;危险比率,0.73;P=0.01) 相比较较低.
- 在完全重血管化组中,心血管死亡或心肌梗塞也较低 (8.9%vs13.5%).
- 安全结果,包括与对比相关的急性损伤,中风或出血,在各组之间是相似的.
结论:
- 由生理学引导的完整重血管化显著降低了75岁及以上心肌梗塞和多血管疾病患者主要不良事件的风险.
- 这种策略在这个老年人群中提供了一个优越的替代方案,而不是在这个老年人群中仅仅是罪祸首的PCI.
更多相关视频
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
相关概念视频
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Acute Coronary Syndrome III: Diagnostic Studies
Cardiac Catheterization I: Pre-Procedure Overview
Acute Coronary Syndrome IV: Interprofessional Care
Acute Coronary Syndrome I: Introduction
Cardiomyopathy V: Interprofessional Care
