在美国医院中,为ST段升高心肌梗塞进行皮肤冠状动脉干预的可能性变化
Ashwin S Nathan1,2, Kevin F Kennedy3, Kriyana P Reddy1
1University of Pennsylvania Philadelphia PA USA.
Journal of the American Heart Association
|February 19, 2025
概括
对于ST段升高心肌梗塞 (STEMI) 的皮革冠状动脉干预 (PCI) 存在变化. 超过3.5%的STEMI患者没有接受PCI,一些医院的非治疗率超过5%.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 穿皮冠状动脉干预 (PCI) 是ST段升高心肌梗塞 (STEMI) 的关键治疗方法.
- 在风险较高的STEMI患者中,PCI的利用可能存在变化.
- 了解治疗模式和医院一级的变化对于优化护理至关重要.
研究的目的:
- 描述当前的治疗选择模式,以STEMI患者的罪祸首病变.
- 为了识别和量化STEMI的PCI利用的医院级变异性.
- 分析与没有进行PCI相关的患者特征.
主要方法:
- 使用了国家心血管数据注册表 (NCDR) 的胸痛-心肌梗塞 (CPMI) 注册表.
- 包括2019年1月1日至2023年3月31日期间来自美国582家医院的178,984名STEMI患者.
- 对那些接受PCI和没有接受PCI的患者的特征和结果进行了比较.
主要成果:
- 总体而言,有3.5% (6,180名患有罪祸首病变的STEMI患者) 没有接受PCI.
- 没有接受PCI的患者年龄较大,患心力衰竭的可能性更高,在抵达前心脏骤停的发病率更高.
- 与接受PCI的患者相比,非PCI患者的预测和观察死亡率显著更高.
结论:
- 在美国医院中,STEMI患者的PCI率存在显著的变化.
- 大约四分之一的美国医院报告说,超过5%的STEMI患者没有接受PCI.
- 在某些情况下,观察到的和预测到的死亡率之间的差异可能表明避免风险的治疗行为.
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