穿皮冠状动脉干预ST升高心肌梗塞复杂的心脏性休克在一个超级老龄化社会
Kensaku Nishihira1, Satoshi Honda2, Misa Takegami3,4
1Department of Cardiology, Miyazaki Medical Association Hospital, 1173 Arita, Miyazaki 880-2102, Japan.
European heart journal. Acute cardiovascular care
|September 19, 2023
概括
穿皮冠状动脉干预 (PCI) 显著降低了ST段升高心肌梗塞与心脏性休克 (STEMICS) 的住院死亡率. 这种益处甚至在老年患者中也被观察到,这表明仅仅年龄不应该阻止这种拯救生命的治疗.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 急性心肌梗塞研究研究
背景情况:
- 由心脏性休克 (STEMICS) 复杂的ST段升高心肌梗塞具有很高的死亡率.
- 预期寿命的增加导致急性心肌梗塞 (AMI) 接受干预的老年患者越来越多.
- 穿皮冠状动脉干预 (PCI) 越来越多地用于急性心肌梗塞 (AMI) 患者,包括老年人.
研究的目的:
- 为了研究患有STEMICS.患者的特征.
- 评估PCI对STEMICS患者住院死亡率的影响.
- 评估PCI在老年STEMICS患者中的有效性.
主要方法:
- 日本AMI注册表 (JAMIR) 数据库 (2011-2016) 的回顾性分析.
- 2760名STEMICS患者的比较:2396人接受了PCI,而364人没有.
- 对789名年龄≥80岁的患者进行亚组分析.
主要成果:
- 对于STEMICS的住院死亡率为34.6%,其中69.3%接受机械循环支持.
- PCI与显著降低的住院死亡率有关 (31.3%与56.0%,P<0.001).
- PCI独立地减少了老年患者的住院死亡率 (调整的OR,0.508) 和心脏病死亡率 (调整的OR,0.524).
结论:
- 在日本,PCI有效地减少了患有STEMICS的老年患者的住院心脏病死亡.
- 年龄不应成为考虑在STEMICS患者中进行PCI的障碍.
- 对于STEMICS来说,PCI提供了一个潜在的有益的侵入性疗法,无论年龄如何.
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