洞察皮肤冠状动脉干预和跨导管大动脉置换的最佳时间
Dae Yong Park1, Matheus Simonato2, Yousif Ahmad3
1Department of Medicine, Cook County Health, Chicago, IL.
Current problems in cardiology
|August 29, 2023
概括
在通管大动脉置换 (TAVR) 的同一天进行皮肤冠状动脉干预 (PCI) 与更好的结果有关. 与PCI和TAVR同时使用,与PCI后不久的TAVR相比,减少了90天的再入院和急性损伤.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健研究成果 研究成果
背景情况:
- 许多接受过导管大动脉置换 (TAVR) 的患者同时存在冠状动脉疾病,需要重新血管化.
- 与TAVR相关的穿皮冠状动脉干预 (PCI) 的最佳时间尚未确立,这影响了临床决策.
研究的目的:
- 评估PCI时间对TAVR后临床结果和再接收的影响.
- 为了比较PCI和TAVR程序之间的不同间隔的结果.
主要方法:
- 国家再接收数据库 (2016-2019) 的回顾性分析.
- 根据PCI-TAVR时间,患者被分为三组:同一天,PCI后TAVR≤30天,PCI后TAVR>30天.
- 医院死亡率,急性损伤,非家庭出院和90天再入院的比较.
主要成果:
- 在PCI-TAVR时间组中没有观察到在医院死亡率的显著差异.
- 与同日手术相比,在PCI后≤30天进行的TAVR与急性损伤 (aOR1.49),非家庭出院 (aOR1.53) 和90天再入院 (aOR1.35) 的几率增加有关.
- 同时进行PCI和TAVR的患者在90天内重新入院和急性损伤的几率较低.
结论:
- 同一天的PCI和TAVR与有利的结果有关,包括减少急性损伤和90天的再入院.
- 在PCI后不久 (≤30天) 进行TAVR与较差的结果有关.
- 同时进行PCI和TAVR应考虑在接受TAVR的冠状动脉疾病患者中进行选择.
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