围手术期心肌坏死对近期临床预后的影响

IF 0.3 Q4 CRITICAL CARE MEDICINE

Egyptian Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI:10.1016/j.ejccm.2017.03.002

Yosef Haggag, Mohamed Saleh, Mahmoud Khaled, Amr Elhadidy

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引用次数: 0

摘要

背景围手术期心肌坏死(PPN)是否与围手术期心肌梗死(PMI)具有同样的不良预后价值尚无可靠的数据。我们的目的是评估PPN对短期临床结果的影响。方法对100例非ST段抬高急性冠状动脉综合征患者行PCI治疗。根据PPN发生情况将患者分为两组，随访3个月。排除PMI患者。结果30例(30%)患者在住院期间和随访3个月期间发生PPN的主要心脏不良事件(MACE)风险较高(分别为43.3%和66.7%，12.9%和14.3%;p & lt;0.001)。PPN更容易发生在老年人、糖尿病患者、既往梗死患者和心力衰竭患者(p值:0.05)，以及病程较长、病变较复杂的患者(p值分别为0.006和0.001)。改良Gensini评分(MGS)每增加1个单位，术后并发症发生率增加1.2倍(P值0.046)，术后术后短期MACE发生率增加5.7倍(P值0.003)。结论sppn患者短期预后较差。PPN多见于糖尿病、心力衰竭、梗死患者和有复杂病变的患者。

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Impact of periprocedural myocardial necrosis on short term clinical outcome

Background

No reliable data whether periprocedural myocardial necrosis (PPN) has same poor prognostic value as periprocedural myocardial infarction (PMI) or not. We aimed to assess the impact of PPN on short term clinical outcome.

Methods

100 patients admitted with non ST elevation acute coronary syndrome and underwent PCI were enrolled. Patients were grouped according to the occurrence of PPN into 2 groups, and were followed for 3 months. Patients with PMI were excluded.

Results

30 patients (30%) had PPN and were associated with higher risks of major adverse cardiac events (MACE) during the hospital and 3 months follow up (43.3% and 66.7% vs. 12.9% and 14.3% respectively; p < 0.001). PPN was more likely to occur in older, diabetic, previously infracted, and heart failure patients (p value: <0.05), in addition to patients who had lengthy and more complex lesions (p value 0.006 and <0.001 respectively). Each unit increase in Modified Gensini Score (MGS) increased odds of procedural complications 1.2 times, (P value 0.046), which in turn increased odds of short term MACE 5.7 times, (P value 0.003).

Conclusions

PPN are associated with poor short term prognosis. PPN occurs more in diabetic, heart failure, infracted patients and those who have complex lesions.

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来源期刊

Egyptian Journal of Critical Care Medicine

自引率

0.00%

发文量

审稿时长

42 weeks

期刊介绍： The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.