冠状动脉微血管功能评估使用冠状动脉血管学衍生微循环阻力指数在患有ST段升高心肌梗塞的患者中进行初级皮肤冠状动脉干预
Ming Li1, Xi Peng1, Naixin Zheng1
1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
冠状动脉微血管功能障碍在初级穿皮冠状动脉干预 (PCI) 后的ST段升高心肌梗塞 (STEMI) 患者中很常见. 微循环阻力 (caIMR) 的冠状动脉血管学衍生指数升高预测主要的不良心血管事件.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 在ST段升高心肌梗塞 (STEMI) 的初级皮肤穿透冠状动脉干预 (PCI) 后,冠状动脉微血管功能评估是有限的.
- 冠状动脉血管学衍生微循环阻力指数 (caIMR) 提供了一种评估心脏病相关动脉 (IRA) 中微血管功能的方法.
研究的目的:
- 在接受初级PCI的STEMI患者中使用caIMR评估冠状动脉微血管功能.
- 确定caIMR和主要心血管不良事件 (MACE) 后初级PCI之间的关联.
主要方法:
- FlashAngio系统用于测量157名STEMI患者的caIMR,这些患者是初级PCI后的患者.
- MACE被定义为心脏死亡率,目标血管再血管化和心力衰竭,心肌梗塞或胸痛再住院的复合物.
主要成果:
- 大约30%的STEMI患者成功进行初级PCI,IRA caIMR<40.
- IRA caIMR显著高于参考容器的caIMR (p < 0.001).
- 一个IRAcaIMR≥40与较高的3个月和1年的MACE率有关,主要是由于心力衰竭,心肌梗塞或胸痛而重新住院.
结论:
- 在初级PCI后,STEMI患者经常表现出冠状动脉微血管功能障碍,由升高的IRA caIMR表明.
- 一个IRAcaIMR≥40独立预测MACE在3个月和1年在STEMI患者后初级PCI.
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