住院期间缩血压的变化和穿皮冠状动脉干预后发生的出血事件
Yasuhiro Otsuka1, Masanobu Ishii2, So Ikebe3
1Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Open heart
|December 24, 2024
概括
在住院期间血压升高会增加皮肤冠状动脉干预 (PCI) 后患者出血的风险. 仔细的血压管理对于防止PCI后发生重大出血事件至关重要.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 临床研究 临床研究
背景情况:
- 高血压是出血事件的已知危险因素.
- 血压 (BP) 变化对穿皮冠状动脉干预 (PCI) 后出血的影响尚不清楚.
- 哈斯-布莱德得分包括高血压,但不能完全捕捉PCI恢复期间的BP动态.
研究的目的:
- 调查在接受PCI的患者住院期间缩血压 (SBP) 变化和重大出血事件之间的关联.
- 在这个患者队列中确定与高血压相关的因素.
主要方法:
- 从一个多中心的日本数据库 (2013年4月至2019年3月) 追溯分析了6351名接受PCI的患者.
- 患者分为高血压 (≥20毫米升),无变化 (-20至<20毫米升) 和降低血压 (<-20毫米升) 的组.
- 主要结局:三年内发生严重出血 (中度或重度).
主要成果:
- 高血压组显示了显著较低的吸收SBP和较高的排放SBP.
- 住院期间血压升高独立地与严重出血事件的显着更高风险相关 (HR: 1.885; 95% CI, 1.294-2.748).
- 高血压的独立预测因素包括女性性别,慢性冠状动脉综合征,外周动脉疾病和慢性病.
结论:
- 住院期间缩血压升高是PCI后重大出血事件的重要危险因素.
- 有效的血压管理策略对于改善结局和预防PCI后患者出血至关重要.
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