[根据俄罗斯急性心肌梗死登记--REGION-IM，ST 段抬高型心肌梗死再灌注疗法的特点]。

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-02-29 DOI:10.18087/cardio.2024.2.n2601

S A Boytsov, R M Shakhnovich, S N Tereschenko, A D Erlikh, D V Pevsner, R G Gulyan, Yu K Rytova, N Yu Dmitrieva, Ya M Voznyuk, N A Musikhina, O A Nazarova, N A Pogorelova, G K Sanabasova, A V Sviridova, I V Sukhareva, A S Filinova, Yu V Shylko, G A Shirikova

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引用次数: 0

摘要

目的：基于俄罗斯REGION-IM登记处的数据，研究ST段抬高型心肌梗死（STEMI）患者再灌注治疗在实际临床实践中的特点：REGION-IM是一项多中心前瞻性观察研究。观察期分为三个阶段：住院期间、纳入登记册后的 6 个月和 12 个月。患者的病历包括人口统计学和病史数据、本次心肌梗死病例的信息，包括首次出现症状的时间、首次与医务人员接触的时间和入院时间、冠状动脉造影（CAG）数据、经皮冠状动脉介入治疗（PCI）数据和溶栓治疗（TLT）信息：88.9%的 STEMI 患者接受了再灌注治疗。60.6%的患者进行了初级PCI（pPCI）治疗。从出现症状到进行 pPCI 的中位时间为 315 分钟 [195; 720]。从心电图到 pPCI 的中位时间为 110 分钟 [84；150]。7.4%的病例进行了孤立 TLT，20.9%的病例采用了药物介入治疗策略。从心电图到 TLT（院前和院内）的中位时间为 30 分钟 [10；59]，而从心电图到院前 TLT 的中位时间为 18 分钟 [10；39]，63% 的患者在诊断后 10 分钟以上才进行 TLT。73%的患者在TLT后进行了PCI治疗：结论：近年来，俄罗斯联邦 STEMI 再灌注治疗的频率显著增加。pPCI 的高频率值得注意，但 pPCI 的时机并不总是符合临床指南。本次登记的结果证实，在现实的临床实践中，对药物介入策略的需求很高。考虑到地理和后勤特点，及时实施心肌再灌注需要院前 TLT。然而，尽管 TLT 已被证实能在发现急性心肌梗死后的最短时间内发挥最大疗效，但在俄罗斯联邦，TLT 的使用频率仍然不足。

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[Features of the Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction According to the Russian Registry of Acute Myocardial Infarction - REGION-IM].

Aim: Based on data from the Russian REGION-IM registry, to study the features of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI) in real-life clinical practice.

Material and methods: REGION-IM is a multicenter prospective observational study. The observational period is divided into 3 stages: during the stay in the hospital and at 6 and 12 months after inclusion in the registry. The patient's records contain demographic and history data; information about the present case of MI, including the time of the first symptom onset, first contact with medical personnel, and admission to the hospital; coronary angiography (CAG) data, percutaneous coronary intervention (PCI) data, and information about the thrombolytic therapy (TLT).

Results: Reperfusion therapy was performed in 88.9 % of patients with STEMI. Primary PCI (pPCI) was performed in 60.6 % of patients. The median time from the onset of symptoms to pPCI was 315 minutes [195; 720]. The median time from ECG to pPCI was 110 minutes [84;150]. Isolated TLT was performed in 7.4 %, pharmaco-invasive treatment tactics were used only in 20.9 % of cases. The median time from ECG to TLT (prehospital and in-hospital) was 30 minutes [10; 59], whereas the median time from ECG to prehospital TLT was 18 minutes [10; 39], and in 63 % of patients, TLT was performed more than 10 minutes after diagnosis. PCI followed TLT in 73 % of patients.

Conclusion: The frequency of reperfusion therapy for STEMI in the Russian Federation has increased considerably in recent years. The high frequency of pPCI is noteworthy, but the timing of pPCI does not always comply with clinical guidelines. The results of this registry confirm the high demand for pharmaco-invasive strategies in real-life clinical practice. Taking into account geographical and logistical features, implementing timely myocardial reperfusion requires prehospital TLT. However, the TLT frequency in the Russian Federation is still insufficient despite its proven maximum effectiveness in the shortest possible time from the detection of acute MI.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.