在外科手术期间心肌梗塞后的心脏病评估的频率和影响
Anthony Hung1, R Parker Ward2, Daniel S Rubin3
1Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
Clinical cardiology
|March 21, 2025
概括
在非心脏手术后经历了手术前心肌梗塞 (PMI) 的五分之一的患者没有接受心脏病评估. 这一评估与指南导向医学治疗 (GDMT) 和诊断测试的使用增加有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 非心脏手术后的外科手术期心肌梗塞 (PMI) 是患者发病率和死亡率的主要原因.
- 目前的管理包括成像和指南导向医学治疗 (GDMT),但医生评估的利用和作用仍然不清楚.
研究的目的:
- 评估非心脏手术后PMI患者心脏病评估的频率.
- 确定心脏病评估与使用指南推护理之间的关联.
主要方法:
- 来自IBM MarketScan (2016-2021) 对45岁以上PMI患者的索赔数据的分析.
- 用回归模型来检查心脏病评估与接受GDMT,缺血检测和心声回声学之间的关系.
主要成果:
- 在5660名PMI患者中,有19%没有接受心脏病评估.
- 心脏病学评估与更高的GDMT处方率 (78.8%vs74.0%),缺血检测 (38.2%vs23.0%) 和心声回声 (75.9%vs53.6%) 相关.
结论:
- 很大一部分PMI患者没有接受心脏病专家的评估.
- 心脏病评估与加强对推的PMI后管理策略的遵守有关.
相关概念视频
Pulse rhythm
743
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
743
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
76
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
76
Imaging Studies for Cardiovascular System I:Echocardiography
280
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
280
Exercise and Cardiovascular Response
683
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
683
Pathophysiology of Cardiac Performance
499
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
499


