在患有非ST段升高心肌梗塞的移植患者中,左心导管的利用不足
Ahmad Mustafa1,2, Samer Asmar1, Chapman Wei1
1Department of Internal Medicine, Staten Island University Hospital/Northwell Health, Staten Island, NY, USA.
概括
患有心脏病发作症状的移植患者接受的心脏手术较少. 冠状动脉扫描显著降低了死亡率和并发症,表明好处超过了感知到的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 移植医学 移植医学 移植医学
背景情况:
- 心血管疾病是移植患者的主要死亡原因.
- 在这些患者中,害怕对比诱导的神经病变可能会阻止必要的冠状动脉血管造影.
研究的目的:
- 调查冠状动脉血管学在患有非ST段升高心肌梗塞的移植患者的利用和结果.
- 为了比较左心导管在移植患者和非移植患者的安全性和有效性.
主要方法:
- 使用了国家住院样本 (NIS) 数据库,用于非ST段升高心肌梗塞的患者.
- 将患者分层分为移植 (KT) 和非KT队列.
- 雇员倾向匹配和回归分析,以比较结果,包括死亡率,心律失常,急性损伤/急性功能衰竭 (AKI/ARF) 和延长住院时间 (ELOS).
主要成果:
- 与非移植患者相比,移植患者接受左心导管治疗 (LHC) 的可能性较低.
- 在接受LHC的患者中,移植患者的死亡率,AKI/ARF,心律失常和ELOS显著降低.
- 比赛后的分析证实,接受LHC.脏移植的脏移植患者心律不整,AKI/ARF和ELOS的风险降低.
结论:
- 移植脏的患者在非ST段升高心肌梗塞时不经常接受冠状动脉造影.
- 冠状动脉血管造影和再血管化与改善的结果有关,包括降低发病率和死亡率.
- 对比引起的脏病的潜在风险不应该阻止脏移植患者接受有益的左心导管治疗.
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