同一天出院的结果慢性全闭塞 皮肤穿透冠状动脉干预
Sant Kumar1, Sudhir Thotakura2, Primero Ng3
1Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA; Department of Cardiology, Creighton University School of Medicine, Phoenix, AZ, USA.
The American journal of cardiology
|February 14, 2026
概括
经过慢性全闭性皮肤通冠状动脉干预 (CTO PCI) 后的当日出院对于精心挑选的患者是安全的. 较低的并发症负担和更好的功能与成功的当天出院结果有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
背景情况:
- 当日出院 (SDD) 越来越多地采用皮肤穿刺冠状动脉干预 (PCI).
- 关于SDD的安全性和可行性的数据有限,特别是在慢性全闭性PCI (CTO PCI) 后.
研究的目的:
- 评估慢性全封闭皮肤冠状动脉干预 (CTO PCI) 后的当天出院 (SDD) 的安全性和结果.
- 为了比较30天的主要不良心脏和脑血管事件 (MACCE) 或SDD和非SDD患者之间的再住院率.
主要方法:
- 从2019年至2023年在美国单一中心对1273个CTO PCI程序进行了回顾性分析.
- 对SDD (n=352) 与非SDD患者进行比较.
- 主要终点:30天的MACCE或再住院. 二次分析:多变量考克斯回归和递归分区.
主要成果:
- SDD患者具有较低的并发症负担 (查尔森并发症指数) 和更好的功能 (eGFR).
- 在医院内MACCE为SDD的0%,而非SDD的2.0% (p<0.001).
- 30天的MACCE/再住院在SDD组显著较低 (4.3%对7.9%,p=0.021). 身体质量指数,CCI和前期解剖/再进入使用是不良事件的独立相关值,而不是SDD本身.
结论:
- 在CTO PCI后的当日出院 (SDD) 是安全的,并且在精心挑选的患者队列中是可行的.
- 诸如并发症负担,功能,程序复杂性和地理距离等因素影响SDD决策.
- 递归分区确定了CCI,eGFR和距离PCI中心的距离作为SDD队列中的关键风险歧视因素.
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