在对STEMI进行初级皮肤冠状动脉干预后的心室心律不整
Jennifer A Rymer1, Zachary K Wegermann1, Tracy Y Wang2
1Department of Cardiology, Duke University Hospital, Durham, North Carolina.
在经皮冠状动脉干预 (PCI) 后,小比例的ST段升高心肌梗塞 (STEMI) 患者经历了晚期腹腔动心 (VT) 或腹腔动 (VF). 然而,这些事件,特别是心脏骤停,很少发生,并且与较高的死亡率有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床研究 临床研究
背景情况:
- 在ST段升高心肌梗塞 (STEMI) 的初级穿皮冠状动脉干预 (PCI) 后,死亡风险较低.
- 在STEMI和PCI之后,心室动脉冲动 (VT) 和心室 (VF) 的住院风险不太清楚.
- 了解晚期VT/VF风险对于优化STEMI后护理至关重要.
研究的目的:
- 在STEMI患者中评估初级PCI后晚期静脉瘤和静脉瘤的发病率和危险因素.
- 确定晚期VT/VF与住院死亡率之间的关联.
主要方法:
- 一项大型队列研究利用美国国家心血管数据注册表胸痛-MI注册表.
- 包括患有STEMI的成年人 (≥18岁),接受初级PCI (2015-2018) 治疗.
- 多变量逻辑回归分析了晚期VT/VF的风险及其与心脏骤停和死亡率的关联.
主要成果:
- 在174,126名STEMI患者中,2.4%的患者经历了晚期静脉瘤或静脉瘤 (PCI后≥1天).
- 晚期VT/VF与显著增加的住院死亡率有关 (AOR 6.40整体,8.74无并发性STEMI).
- 左下心室喷射分数 (LVEF) 是晚期VT/VF与心脏骤停的关键风险因素.
结论:
- 在STEMI初级PCI后的晚期VT/VF发生在很少一部分患者中,但具有相当大的死亡风险.
- 晚期VT/VF与心脏骤停是罕见的,特别是在没有并发症的STEMI病例中.
- 调查结果为有关医院出院时间和PCI后监测策略的决定提供了信息.
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