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远程缺血预调,损伤,以及冠状动脉血管学和干预后的结果:一个随机试验

Ping Jia¹, Gang Zhao², Yuli Huang³

¹Department of Nephrology, Shanghai Medical Center of Kidney; Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.

European heart journal

|March 11, 2025

概括

延迟远程缺血性预调 (RIPC) 在接受冠状动脉血管学或PCI的患者中显著降低了与对比相关的急性损伤 (CA-AKI). 需要进一步的试验来确认临床益处.

科学领域:

心脏病学心脏病学
腎臟病學 (nephrology) 是一種醫學專業.
医疗干预医疗干预

背景情况:

与对比相关的急性损伤 (CA-AKI) 是血管造影手术后的一种风险.
远程缺血性预调 (RIPC) 可以提供对CA-AKI的保护.
延迟RIPC (24小时前) 在冠状动脉血管学 (CAG) 或皮肤冠状动脉干预 (PCI) 后减少CA-AKI的疗效尚未得到充分证实.

研究的目的:

评估推迟RIPC在接受选择性CAG或PCI的患者中预防CA-AKI的有效性.
评估延迟RIPC对二次结果的影响,包括替代疗法和主要心血管不良事件.

主要方法:

一个多中心的随机试验,涉及501名患有CA-AKI风险的患者,接受CAG或PCI.
患者随机分配,接受延迟的RIPC (24小时前) 或假的RIPC.
主要终点是根据KDIGO标准定义的AKI发生率;次要终点包括功能和90天后的临床结果.

主要成果:

与假冒RIPC组 (7.6%) 相比,延迟RIPC组 (3.2%) 的CA-AKI发生率明显较低 (OR 0.4,P = .03).
共有467名患者完成了90天的结局评估.
该试验不足以证明对二次结果的显著影响.

结论:

延迟RIPC在CAG或PCI24小时前进行,可降低风险患者中CA-AKI的发生率.
需要进行更大的试验来证实这些发现,并研究延迟RIPC在减少CA-AKI方面的临床益处.

关键词:

急性损伤是什么?急性损伤是什么?冠状动脉动脉扫描 (Coronary angiography) 是一种冠状动脉动脉扫描.通过皮肤进行冠状动脉干预.远程缺血性预先调节

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