在没有前期治疗的情况下,治疗非ST升高急性冠状动脉综合征的最佳时间
Inês Almeida1, Joana Chin1, Hélder Santos1
1Serviço de Cardiologia, Centro Hospitalar Barreiro-Montijo, Portugal.
概括
对于没有P2Y12抗剂预治疗的非ST段升高急性冠状动脉综合征 (NSTE-ACS),早期的侵入性策略与延迟的方法相比,在一年的死亡率或再住院没有显著差异. 这一发现支持在NSTE-ACS患者中进行冠状动脉扫描的灵活时间.
科学领域:
- 心脏病学
- 干预心脏病学
- 急性冠状动脉综合征
背景情况:
- 对于非ST段升高的急性冠状动脉综合征 (NSTE-ACS) 建议采用侵入性策略.
- 在NSTE-ACS中冠状动脉扫描 (CA) 的最佳时间尚不清楚,尤其是在最近对P2Y12抗剂 (PT) 前期治疗的指导限制之后.
研究的目的:
- 在NSTE-ACS患者中评估早期 (ES; < 24小时) 与延迟 (DS; > 24小时) 冠状动脉扫描的预后影响.
- 评估P2Y12抗剂充满剂量未作为预治疗时的结果.
主要方法:
- 来自葡萄牙急性冠状动脉综合征登记处的619名NSTE-ACS患者的回顾性分析 (2015-2019).
- 排除接受P2Y12抗剂预治疗的患者.
- 早期 (<24小时) 和延迟 (>24小时) CA 组之间的结果比较.
- 多变量逻辑回归以确定一年内全因死亡率和心血管再住院的预测因素.
主要成果:
- 早期和晚期CA组之间在住院不良结果中没有显著差异.
- 在延迟策略组中观察到较高的严重出血率.
- 一年死亡率和心血管再住院的综合终点发生在8. 9%的患者中,两组之间没有显著差异.
结论:
- 在没有接受P2Y12抗剂预治疗的NSTE-ACS患者中,早期的侵入性策略不会增加住院不良事件.
- 与延迟策略相比,早期CA并没有降低一年死亡率或心血管再住院.
- 研究结果表明,在没有预先治疗的NSTE-ACS患者中,CA时间灵活.
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