峰值程序性ACT与腿部接入PCI后的全因死亡率有关
Revathy Sampath-Kumar1, Ori Ben-Yehuda1, Belal Al Khiami1
1Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California.
概括
在输穿皮冠状动脉干预 (PCI) 期间高激活凝血时间 (ACT) 会增加死亡率和出血风险. 辐射接入PCI在不同ACT水平的结果中没有差异,这表明一种更安全的方法.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
背景情况:
- 在皮肤冠状动脉干预 (PCI) 期间对肝素剂量至关重要,以减少缺血事件.
- 然而,与过高的ACT水平相关的风险仍然不清楚,特别是在不同的血管接入方法方面.
研究的目的:
- 调查高峰程序性ACT对接受膜和透射接入PCI的患者并发症和死亡率的影响.
- 基于ACT的测试结果进行比较,以确定潜在的安全门.
主要方法:
- 使用了加州大学圣地亚哥分校健康国家心血管数据注册表CathPCI注册表 (2007-2022).
- 包括接受本土血管PCI的患者,但不包括先前使用冠状动脉旁路移植或比瓦利鲁丁的患者.
- 评估30天和1年的全因死亡率和并发症在ACT地球动物中 (≤228,228-275,≥275).
主要成果:
- 骨外接入:最高ACT三位数 (≥275) 显示显著更高的30天,6个月和1年死亡率 (P < .001).
- 增加的出血并发症 (P = .034) 和需要血液制品 (P = .014) 被观察到与更高的ACT在 transfemoral访问.
- 对于跨射线接入的ACT三角动物,没有发现临床结果或死亡率的显著差异.
结论:
- 转性PCI期间ACT水平升高与30天死亡率,出血和输血需求的增加有关.
- 跨射线接入PCI似乎对ACT变异不那么敏感,没有观察到与较高ACT水平相关的不良结果.
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