在接受皮肤冠状动脉干预的患者中,程序复杂性和出血风险
Ridhima Goel1, Alessandro Spirito2, Davide Cao2
1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
The American journal of cardiology
|January 7, 2026
概括
复杂的穿皮冠状动脉干预 (PCI) 增加了高出血风险 (HBR) 和非高出血风险患者的风险. 这两组在复杂的PCI后,与非复杂的手术相比,都面临更高的重大心脏不良事件和重大出血率.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床结果研究研究
背景情况:
- 在患有高出血风险 (HBR) 的患者中,复杂的穿皮冠状动脉干预 (PCI) 的结果尚未得到充分确立.
- 复杂的PCI涉及治疗多个血管/损伤,使用长支架,或解决具有挑战性的解剖学,如慢性全闭症或左主疾病.
研究的目的:
- 评估复杂的PCI对HBR和非HBR患者主要不良心脏事件 (MACE) 和重大出血的影响.
- 在大量患者队列中,比较复杂和非复杂的PCI程序之间的结果.
主要方法:
- 对16,966名在转诊中心接受PCI的患者的回顾性分析.
- 根据既定的标准,患者被归类为HBR.
- 复杂的PCI是由特定的程序特征定义的 (例如,处理的血管/支架/损伤数量,支架长度,特定的损伤类型).
主要成果:
- 复杂的PCI与在HBR (adj. HR 1.78) 和非HBR (adj. HR 1.82) 患者与非复杂的PCI相比.
- 在复杂的PCI后,在HBR (adj. HR 1.55) 和非HBR (adj. HR 1.36) 的小组.
- 这些关联无论出血风险状况如何,都保持显著.
结论:
- 复杂的PCI独立地增加了一年内缺血事件 (MACE) 和大出血的风险.
- 这些发现强调需要仔细考虑PCI患者的程序复杂性,特别是那些高出血风险的患者.
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