急性ST段抬高型心肌梗死经皮冠状动脉介入治疗患者亚最佳再灌注和短期死亡率的预测因素

M. Abdelmoneum, O. S. Arafa, Oubibi Mohamed, Ebtssam Mohamed, H. Allam
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引用次数: 0

摘要

背景:亚最佳再灌注的预测因素尚不清楚。目的:本研究旨在确定在诊断为急性ST段抬高型心肌梗死(STEMI)并接受初次经皮冠状动脉介入治疗(pPCI)的患者中,可能指示次优再灌注和短期死亡率的因素。患者和方法:这项在本哈大学医院和国家心脏研究所进行的多中心前瞻性比较研究,包括400名患者(年龄1岁,血栓负担重、预矫正、多支架插入和支架长度较长是PPCI后SOR的预测因素。而长期服用β受体阻滞剂(BB)和血管紧张素转换酶抑制剂(ACEI)的患者发生SOR的可能性较小。此外,SOR患者更有可能出现院内心律失常、心力衰竭、急性二尖瓣返流和院内死亡率。此外,它还会增加6个月的再出血风险和死亡率。结论:预测经皮冠状动脉介入治疗后无再流的发生可以通过考虑各种因素来实现,如临床数据、实验室结果、血管造影特征和手术特点。研究发现,血栓负荷重、预矫正、血脂异常、支架长度较长、PCI疼痛时间以及出现时RBG>300(mg/dL)是SOR最可预测的变量。发现长期使用BB和ACEI是降低TIMI9h可能性的重要独立因素。9h被认为是无再流患者死亡率的最可预测变量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention
Background: Predictors of Suboptimal reperfusion are still unclear. Aim: This study aimed to determine the factors that may indicate suboptimal reperfusion and short-term mortality in patients who were diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI). Patients and methods: This multicenter prospective comparative study, conducted at Benha University hospitals and National Heart Institute, included 400 patients (age<18 years and both sex) with acute STEMI, who were treated with PPCI. They were divided equally into 2 groups; suboptimal and optimal reperfusion groups (TIMI < III Vs.TIMI III respectively). Clinical data was collected. ECG, laboratory investigations, echocardiographic study, PPCI and 6 months follow up were done to all patients included. Results: This study showed that advanced age (60.4±8.2), family history of CAD, dyslipidemia, being diabetic, prolonged Pain to PCI time, higher random blood sugar (RBG) at the time of presentation, Killip class >1, heavy thrombus burden, prediltation, multiple stents insertion and longer stent length are predictors of the SOR after PPCI. While, Patients on long term beta blockers (BB) and angiotensin-converting enzyme inhibitor (ACEI) are less likely to develop SOR. Furthermore, patients with SOR are more likely to develop in-hospital arrhythmias, heart failure, acute mitral regurge and inhospital mortality. Additionally, it increases 6-months risk of reischemia and mortality. Conclusions: Predicting the occurrence of no-reflow following pPCI can be achieved by considering various factors, such as clinical data, laboratory results, angiographic features, and procedural characteristics. Heavy thrombus burden, prediltation, dyslipidemia, longer stent length, pain to PCI time and RBG >300 (mg/dL) at the time of presentation were found to be the most predictable variables to SOR. Long term use of BB and ACEI were found to be significant independent factors that decreased the likelihood of TIMI9h were considered the most predictable variables to mortality in no reflow.
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来源期刊
Cardiometry
Cardiometry MEDICAL LABORATORY TECHNOLOGY-
自引率
0.00%
发文量
0
审稿时长
6 weeks
期刊介绍: Cardiometry is an open access biannual electronic journal founded in 2012. It refers to medicine, particularly to cardiology, as well as oncocardiology and allied science of biophysics and medical equipment engineering. We publish mainly high quality original articles, reports, case reports, reviews and lectures in the field of the theory of cardiovascular system functioning, principles of cardiometry, its diagnostic methods, cardiovascular system therapy from the aspect of cardiometry, system and particular approaches to maintaining health, engineering peculiarities in cardiometry developing. The interdisciplinary areas of the journal are: hemodynamics, biophysics, biochemistry, metrology. The target audience of our Journal covers healthcare providers including cardiologists and general practitioners, bioengineers, biophysics, medical equipment, especially cardiology diagnostics device, developers, educators, nurses, healthcare decision-makers, people with cardiovascular diseases, cardiology and engineering universities and schools, state and private clinics. Cardiometry is aimed to provide a wide forum for exchange of information and public discussion on above scientific issues for the mentioned experts.
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