有或没有ST升高的急性冠状动脉封闭:对手术结果和所有原因的长期死亡率的影响
Mohammed Abusharekh1, Jürgen Kampf1, Iryna Dykun1
1Department of Cardiology and Vascular Medicine, The West German Heart and Vascular Center Essen, University Hospital Essen, Hufeland Street 55, 45147 Essen, Germany.
European heart journal. Quality of care & clinical outcomes
|January 9, 2024
概括
患有非ST升高心肌梗塞 (NSTEMI) 经历急性全闭症 (ATO) 的患者面临与ST升高心肌梗塞 (STEMI) 患者相似的风险和死亡率. 这表明,根据闭塞状况对心肌梗塞进行分类更有信息意义.
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:
- 在非ST升高心肌梗塞 (NSTEMI) 患者中经常观察到急性全闭症 (ATO).
- 与ST升高心肌梗塞 (STEMI) 相比,NSTEMI中ATO的预后影响需要进一步调查.
研究的目的:
- 为了比较STEMI和NSTEMI患者的手术结果和长期死亡率,根据ATO的存在或不存在分层.
- 根据动脉封闭状态来评估分类急性心肌梗塞 (AMI) 的临床意义.
主要方法:
- 对接受冠状动脉血管造影的2269名AMI患者 (2004-2019) 的回顾性分析.
- 通过TIMI 0-1流量或TIMI 2-3定义的ATO,峰值热素>100x正常的上限.
- 多变量考克斯回归用于评估呈现和长期死亡率之间的关联.
主要成果:
- 在1605名NSTEMI患者中,471人 (29.3%) 患有ATO.
- 与ATO阳性NSTEMI和STEMI患者相比,ATO阳性NSTEMI和STEMI患者的心脏性休克和无逆流率更高.
- 与ATO阴性NSTEMI相比,ATO阳性NSTEMI和STEMI与显著增加的长期死亡率 (分别为1.60和1.55的危险比率) 相关.
结论:
- 患有ATO的NSTEMI患者表现出不良的程序结果和增加的长期死亡率,反映了STEMI中看到的结果.
- 动脉堵塞的存在是决定AMI患者预后的一个关键因素.
- 将AMI按闭塞状态分类,而不是仅仅根据STEMI和NSTEMI分类,可能会提供更准确的预后框架.
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