在患有ST段升高心肌梗塞的患者中,远端辐射接入与跨辐射接入:DRAMI试验
Jun-Won Lee1, Chan Joon Kim2, Bong-Ki Lee3
1Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea.
JACC. Advances
|September 30, 2025
概括
在ST升高心肌梗塞 (STEMI) 患者中,对于穿孔成功,远端辐射接入 (DRA) 没有被发现与跨辐射接入 (TRA) 不相差. 然而,这两种方法在初级穿皮冠状动脉干预 (PCI) 中表现出相似的安全性和有效性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管接入 血管接入
背景情况:
- 远端辐射接入 (DRA) 是冠状动脉手术中超辐射接入 (TRA) 的新兴替代方案.
- 在ST段升高心肌梗塞 (STEMI) 患者中,DRA的疗效的证据有限.
研究的目的:
- 评估DRA是否在接受初级皮肤冠状动脉干预 (PCI) 的STEMI患者中不劣于TRA.
主要方法:
- 一个多中心,开放标签,随机对照试验,涉及354名STEMI患者.
- 患者被随机分配到DRA或TRA,以刺穿成功率作为主要终点.
- 非劣势性测试使用意图治疗,每条协议,以及作为治疗的分析.
主要成果:
- 刺穿成功率为DRA的94.3%,对TRA (治疗意图分析) 的96.1%.
- 在意图治疗和每条协议分析中,DRA未能证明非劣势性.
- 在接受治疗的人群中观察到非劣质性;手术成功和安全性在不同组之间是可比的.
结论:
- 在STEMI患者中,远端辐射接入 (DRA) 与跨辐射接入 (TRA) 相比,没有满足穿孔成功的非劣质标准.
- 两条通道都表现出类似的程序有效性和安全性.
- 需要进行更大,更强大的研究来证实这些发现,并进一步验证STEMI中的DRA.
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