穿皮冠状动脉干预后的周围手术性心肌梗塞和长期死亡率:一个元分析
Luca Paolucci1, Fabio Mangiacapra2,3, Sara Sergio2
1Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy.
European heart journal
|May 14, 2024
概括
周围手术性心肌梗塞 (PMI) 增加了穿皮冠状动脉干预后的死亡率,在不同的定义中风险有所不同. 了解这些定义对于患者的治疗结果至关重要.
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:
- 关于周围手术性心肌梗塞 (PMI) 和PCI后死亡率存在相互矛盾的数据.
- 不同的PMI定义 (UDMI,ARC-2,SCAI) 使预后评估复杂化.
研究的目的:
- 用UDMI,ARC-2和SCAI定义来评估PMI的发病率和预后影响.
- 为了比较不同PMI定义与PCI后死亡率的关联.
主要方法:
- 对报告PMI调整后影响估计的研究进行系统的搜索.
- 使用随机效应模型的元分析,以所有原因的死亡为主要结果.
- 包括根据有或没有缺血的生物标志物升高来定义PMI的研究 ("辅助标准").
主要成果:
- 包括19项研究和109568名患者.
- 在UDMI,ARC-2和SCAI定义中,PMI发生率下降.
- 所有的PMI定义都独立地与所有原因的死亡率增加有关,与不同的危险比率有关.
结论:
- 所有国际PMI定义都与PCI后更高的全因死亡风险有关.
- 这种关联的强度根据定义灵敏度和预后相关性而有所不同.
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