冠心内成像指导穿皮冠心干预结果在患有心脏性休克的个体中
Mohamed O Mohamed1,2, Tim Kinnaird3, Syed Tanveer Rab4
1Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK.
概括
导向的冠状动脉内成像 (ICI) 穿皮冠状动脉干预 (PCI) 在患有心脏性休克的急性冠状动脉综合征患者中显著减少了主要的心血管不良事件. 尽管使用量增加,但ICI仍未得到充分利用,这突显了其改善长期生存的预后益处.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗成像医学成像
背景情况:
- 有限的数据存在于皮肤冠状动脉干预 (PCI) 中的冠状动脉内成像 (ICI) 实用性,用于急性冠状动脉综合征 (ACS) 患有心脏性休克 (CS) 的患者.
- 这些高风险患者面临着支架血栓形成 (ST) 的重大威胁.
研究的目的:
- 评估ICI在PCI期间使用ICI对CS患者ACS在医院治疗结果的影响.
- 为了比较ICI指导和血管学指导的PCI之间的主要不良心血管和脑血管事件 (MACCE) 和出血率.
主要方法:
- 在英格兰和威尔士 (2014-2020年) 的ACS患者进行PCI手术的回顾性分析.
- 分层分为ICI引导和血管学引导的组.
- 多变量逻辑回归用于评估住院结果的几率比率 (OR),包括MACCE和重大出血.
主要成果:
- ICI使用率从2014年的5.7%增加了一倍以上,到2020年的13.3%,但仍未充分利用.
- 与血管造影指导组相比,ICI指导组显示MACCE显著降低 (调整后OR为0.65),主要是由于所有原因死亡率降低 (调整后OR为0.65).
- 在其他次要结局,如大出血方面,没有观察到显著差异.
结论:
- 基于ICI指导的PCI与CS患者的显著预后益处有关.
- 建议在CS患者的PCI中增加ICI的使用,以改善长期存活率.
- 尽管证明了益处,但ICI在这个高风险人群中仍未得到充分利用.
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