心脏外科手术可用性和机构手术量对复杂,高风险和指示皮肤冠状动脉干预后临床结果的影响
Wayne C Zheng1, Sara Vogrin2, Jiwon Kim3
1Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia.
概括
复杂,高风险和指示 (CHIP) 穿皮冠状动脉干预 (PCI) 的结果与医院心脏手术可用性或CHIP-PCI体积相似. 高的不良事件率凸显出需要进一步研究重血管化的适宜性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 复杂,高风险和指示 (CHIP) 穿皮冠状动脉干预 (PCI) 越来越常见.
- 对CHIP-PCI的结果和定义各不相同,需要进一步调查.
研究的目的:
- 评估心脏手术可用性对CHIP-PCI结果的影响.
- 评估CHIP-PCI程序量与患者结果之间的关系.
- 分析30天的主要不良心脏和脑血管事件 (MACCE) 和长期死亡率.
主要方法:
- 在澳大利亚维多利亚州 (2014-2021) 的多中心PCI注册表的分析.
- CHIP-PCI是由一个综合风险评分 (≥5分) 定义的,该评分包含多个预后因素.
- 医院按心脏手术可用性和CHIP-PCI年体积三位数 (<16,16-36,>36例) 分层.
主要成果:
- 总共有6476个CHIP-PCI程序被确定 (占所有PCI的7.0%),平均年龄为82岁,并具有很高的并发症负担.
- 30天MACCE和5年死亡率分别为13%和36%.
- 根据心脏手术可用性或CHIP-PCI体积三位数,没有观察到30天MACCE或长期死亡率的显著差异.
结论:
- 在不同的机构体积和心脏手术服务的存在方面,CHIP-PCI结果是可比的.
- 在CHIP-PCI患者中,不良结果的高率强调了需要精确重新血管化的适当性标准的关键需要.
- 进一步的研究对于优化CHIP-PCI程序的患者选择和管理至关重要.
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