在老年肌肉心脏病发作患者多血管疾病的重血管化中未解决的问题

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Rita Pavasini¹, Federico Sanguettoli¹, Luca Zanarelli¹

¹UO Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy.

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|July 30, 2024

概括

患有心肌梗塞和多血管冠状动脉疾病的老年患者面临更高的死亡率和并发症. 这次审查强调了缺乏随机试验,指导心脏病发作老年人复血管化策略.

科学领域:

心脏病学心脏病学
老年医学老年医学
干预心脏病学干预心脏病学

背景情况:

人口老龄化给心脏病学带来了挑战,包括老年人的复杂冠状动脉病变.
患有心肌梗塞 (MI) 和多血管冠状动脉疾病 (CAD) 的老年患者通常很脆弱和并发症.
随机临床试验 (RCT) 低于老年患者,需要对当前知识进行审查.

研究的目的:

系统地审查当前关于老年患者 (≥75岁) 经历多血管冠状动脉疾病心肌梗塞的重血管化策略的知识.
识别知识差距,并指导在这个研究不足的人群中的未来研究.

主要方法:

按照PRISMA指南进行了系统审查.
在PubMed,Cochrane图书馆,谷歌学者和Biomed中央数据库 (2022年1月至2月) 上进行了搜索.
包括的研究集中在75年或更长的患者中,这些患者因多血管性心脏病而住院治疗;选择了36项研究.

主要成果:

多血管CAD影响50-60%的老年心脏病患者,与年轻人相比,住院死亡率翻了一番.
重血管后常见的并发症包括出血和功能衰竭.
对于ST升高MI (STEMI),初级皮肤穿冠状动脉干预比纤维素分解更好,但最佳的再血管化程度尚不清楚. 对于非STEMI (NSTEMI),入侵或保守的策略是选择,具有有限的比较数据.

结论:

这一系统性审查揭示了大量缺乏随机临床试验,以指导STEMI或NSTEMI的老年患者的重血管化策略.
进一步的研究,包括正在进行的试验,对于为这种脆弱人群建立基于证据的指导方针至关重要.

关键词:

冠状动脉疾病是一种冠状动脉疾病.年长的老人老年人老年人.多船型CAD多船型CAD多船型心肌梗塞的心脏病发作年长的年长的年长的年长的

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