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在ST段升高心肌梗塞的初级穿皮冠状动脉干预后的结果,由心脏性冲击复杂化

Yui Okada Nozaki¹, Shoichiro Yatsu¹, Manabu Ogita¹

¹Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan.

Journal of cardiology

|February 19, 2024

概括

患有ST段升高心肌梗塞 (STEMI) 和心脏性休克 (CS) 的患者在初级穿皮冠状动脉干预 (PCI) 后的早期心血管死亡率较高. 然而,长期存活率 (>1年) 与没有CS的人相似.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
急性冠状动脉综合征是什么

背景情况:

初级穿皮冠状动脉干预 (PCI) 是ST段升高心肌梗塞 (STEMI) 的关键治疗方法.
心脏性休克 (CS) 是STEMI的严重并发症,对治疗和结果构成重大挑战.
在临床实践中,评估接受初级PCI的SC患者的长期结果对临床实践至关重要.

研究的目的:

评估接受初级PCI的STEMI和CS患者的临床特征.
评估初级PCI后STEMI患者和没有CS患者的长期心血管死亡 (CVD) 率.
确定影响这一高风险人群结果的因素.

主要方法:

一项观察性队列研究包括1758名从2004年4月至2017年12月接受初级PCI的STEMI患者.
患者根据心脏性休克 (CS) 的存在或不存在来对患者进行分类.
基准分析和多变量考克斯回归被用来评估心血管死亡 (CVD) 在1年和1-10年间隔.

主要成果:

与没有CS (2,9%) 相比,患有CS的STEMI患者 (n=212) 的30天心血管疾病发病率 (26.4%) 显著更高.
里程碑式的分析显示,在CS组中,从0日到1年内,心血管疾病的显著增加 (逻辑等级p < 0.0001).
CS是较高心血管死亡率 (aHR,11.8;p < 0.0001) 的强有力的预测因素,但从1年到10年的心血管疾病发病率在各组之间是可比的 (逻辑等级p = 0.68).

结论:

患有STEMI和CS的患者在初级PCI后的第一年内,心血管死亡的风险要高得多.
尽管最初的死亡率很高,但STEMI患者的长期存活率 (>1年) 幸存于CS的急性阶段,与没有CS的患者相似.
专注于早期治疗和生存对于改善心脏性休克复杂的STEMI患者的长期预后至关重要.

关键词:

心脏发生的冲击是心脏的冲击.心血管死亡率的心血管死亡率冠状动脉疾病是一种冠状动脉疾病.心肌梗塞的心脏病发作通过皮肤进行冠状动脉干预.

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