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急性心力衰竭住院治疗中的早期与晚期跨导管大动脉置换:全国范围的比较分析

Anas Hashem¹, Amani Khalouf¹, Mohamed Salah Mohamed¹

¹Department of Medicine, Rochester General Hospital, Rochester, NY, USA.

Journal of cardiology

|August 18, 2024

概括

在患有严重大动脉狭窄和急性心力衰竭的患者中,早期透管大动脉置换 (TAVR) 与晚期TAVR相比,在调整后的住院结果中没有显著差异. 这项研究强调了TAVR程序中的时机对于这个弱势群体的重要性.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
心脏衰竭管理的管理

背景情况:

严重的大动脉狭窄 (AS) 是美国流行的一种心脏膜疾病.
经过紧急或紧急的跨导管大动脉置换 (TAVR) 患者的临床结果较差.
在急性心力衰竭 (AHF) 的AS患者中,TAVR手术时间对结果的影响仍未得到充分研究.

研究的目的:

为了比较住院死亡率和早期 (<48小时) 和晚期 (≥48小时) 的TAVR之间的临床结果,在住院治疗AHF的患者中.
分析来自美国数据库的现实数据,以评估TAVR时间对患者结果的影响.

主要方法:

利用国家住院样本数据库 (2015-2020年) 确定涉及AHF,大动脉病和TAVR的住院病例.
使用后勤回归建模来检查TAVR时间和临床结果之间的关联.

主要成果:

在25,290次加权的AHF住院治疗中,27.1%接受了早期TAVR,72.9%接受了晚期TAVR.
未经调整的分析显示,晚期TAVR的住院死亡率较高,但经过对共变量进行调整后,这种差异并不显著.
晚期TAVR与心脏骤停的几率增加,机械循环支持的使用,更长的住院时间和更高的成本有关.

结论:

早期TAVR在AHF入院的AS患者中约有25%进行.
虽然未经调整的分析表明早期TAVR的结果有所改善,但在根据患者和医院特征进行调整后没有观察到任何显著差异.

关键词:

急性心力衰竭是什么?急性心力衰竭是什么?临床结果临床结果住院死亡率住院死亡率通过导管更换大动脉门.

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