在ST段升高心肌梗塞的患者中,定量流量比率引导的分阶段皮肤冠状动脉干预
Shenglong Hou1, Xinxin Zhu2, Qi Zhao3
1Department of Cardiology, Heilongjiang Provincial People's Hospital, 150036, Harbin, Heilongjiang, China.
Heliyon
|December 6, 2024
概括
定量流量比率 (QFR) 引导的分阶段皮肤冠状动脉干预 (PCI) 减少了ST段升高心肌梗塞 (STEMI) 多血管冠状动脉疾病患者分阶段PCI的发生率和成本. 这种方法被证明是安全和具有成本效益的,而不会增加主要的不良心脏事件.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管成像 - 心血管成像
- 卫生经济学 卫生经济学
背景情况:
- 在ST段升高心肌梗塞 (STEMI) 中的多血管冠状动脉疾病需要初级穿皮冠状动脉干预 (PCI) 和经常分阶段的PCI.
- 评估定量流量比率 (QFR) 引导的分阶段PCI的有效性,安全性和成本效益对于优化患者管理至关重要.
研究的目的:
- 评估定量流量比率 (QFR) 引导的分阶段PCI策略在多血管冠状动脉疾病的STEMI患者中的效率,安全性和成本效益.
主要方法:
- 一项对2256名STEMI患者进行的回顾性研究,这些患者接受了针对心脏病相关动脉的初级PCI,以及针对非心脏病相关动脉 (NIR) 的分阶段PCI.
- 患者被分为QFR引导的和定量冠状动脉血管学 (QCA) 引导的组.
- 使用QFR≤0.80作为QFR组干预的门;收集了人口统计,临床因素和QFR值的数据.
主要成果:
- 与QCA指导小组相比,QFR指导小组的PCI分阶段率显著降低,每个患者的支架数量减少,PCI分阶段成本降低.
- 长期没有观察到主要心脏不良事件或诊所访问的显著差异,除了目标血管再血管化 (TVR).
- 在NIR动脉中平均QFR值一致 (0.83),无论测量时间如何 (初级与阶段性PCI).
结论:
- QFR指导减少了对具有多血管疾病的STEMI患者进行侵入性血管造影和分阶段PCI的需要.
- 这一策略降低了TVR发生率和医疗费用,而不会影响安全,主要心血管不良事件的不增加证明了这一点.
- 未来的研究应该集中在大型的多中心前性研究上,以确认在STEMI中QFR引导的分阶段PCI的可行性.
相关概念视频
01:23Assessment of blood pressure in brachial artery(two-step method)
2.1K
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
2.1K
01:27Regulation of Stroke Volume
7.3K
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
7.3K
01:22Mitral Stenosis I: Introduction
1.8K
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.8K
01:27Mitral Stenosis IV: Nursing Management
422
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
422
01:17Aortic Regurgitation IV: Nursing Management
453
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
453