通过皮肤冠状动脉干预稳定晚期ST升高心肌梗塞,症状发作时间在12至72小时之间 - - 系统性审查
Shumail Fatima1, Matthew E Harinstein2, Mubashir Hussain3
1Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve Medical University, United States.
概括
穿皮冠状动脉干预 (PCI) 与医学治疗相比,改善了稳定的晚期ST升高心肌梗塞 (STEMI) 患者的结果. 紧急与非紧急的PCI时间在本次审查中没有显著的临床结果差异.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 急性冠状动脉综合征是什么
背景情况:
- 对于在症状发作后12-72小时出现的稳定晚期ST升高心肌梗塞 (STEMI) 的侵入性与保守性治疗,存在临床均衡.
- 在这个患者群体中,穿皮冠状动脉干预 (PCI) 的最佳时间尚不清楚.
研究的目的:
- 在稳定的晚期STEMI中,系统地审查和比较PCI与医疗治疗的结果.
- 通过比较该群体的紧急与非紧急方法来确定PCI的最佳时间.
主要方法:
- 对PubMed,Embase和Cochrane数据库进行系统审查 (至2024年3月).
- 包括的研究比较了稳定的晚期STEMI患者 (12-72小时发病) 的PCI与医疗治疗或紧急与非紧急PCI.
- 使用GRADE和ROBINS-I标准评估的质量和偏差风险.
主要成果:
- PCI显著改善了短期和长期结果,减少了全因死亡率,复发性心脏病发作和心脏病发作的大小 (P < 0.001).
- PCI显示,心脏死亡,心力衰竭,再血管化和喷射小部分的改善没有显著的改善.
- 紧急与非紧急的PCI在临床结果中没有显著差异 (P > 0.05).
- 包括的研究显示异质性;证据质量中度,偏差风险中度至严重.
结论:
- 穿皮冠状动脉干预 (PCI) 对稳定的晚期STEMI患者在12-72小时内呈现的治疗结果优于药物治疗.
- 需要进一步的研究来确定PCI在这个患者队列中的最佳时间.
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