STEMI血管重建术患者的短期预后和院内并发症:来自印度的前瞻性登记

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Ambukeshwar Singh, V. Narain, Jayesh Sharma, G. Chaudhary, P. Vishwakarma, S. Yadav, S. Dwivedi
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引用次数: 0

摘要

背景:与溶栓相比,经皮冠状动脉介入治疗(PCI)是最有效的再灌注治疗,并发症发生率低。目的:我们旨在研究在印度一家大型三级医疗中心进行初级PCI的短期结果。设置和设计:在2015年12月至2016年11月期间,纳入了一个接受初次PCI的ST段抬高型心肌梗死(STEMI)患者的前瞻性队列。受试者和方法:评估人口统计学特征、危险因素、临床特征、住院并发症和30天时的结果。主要结果是死亡、再梗死和重复血运重建的复合结果。急性左心室衰竭(LVF)、完全性心脏传导阻滞(CHB)或缓慢性心律失常、室性心动过速(VT)或室颤、中风和心肌梗死出血的主要溶栓是被认为是次要结果的住院并发症。结果:共有237名经皮冠状动脉介入治疗的STEMI患者入选,占在此期间进行的所有PCI手术的7.5%。平均年龄55.4±11.9岁,男性占86.5%。平均窗口期为5.1±3.18小时,平均门到球囊时间为58.4±11.5分钟。PCI前,最常用的抗血小板药物是氯吡格雷(54.4%)和普拉格雷(55.6%)。抽吸血栓切除术(70.8%)。41.8%的患者需要球囊扩张术。98.3%的患者植入了药物洗脱支架。3.3%的患者出现了主要转归(死亡2.9%,再梗死0.4%),13%的患者出现次要转归。常见的住院并发症是慢性乙型肝炎或缓慢性心律失常(5.0%),其次是急性LVF(4.6%),然后是室性心动过速(2.1%)。CHB和急性LVF是经皮冠状动脉介入治疗STEMI患者的主要住院并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The short outcomes and in-hospital complications in patients with STEMI revascularized with primary PCI: A prospective registry from India
Context: Primary percutaneous coronary intervention (PCI) is the most effective reperfusion therapy with low complication rate in comparison to thrombolysis. Aims: We aimed to study the short-term outcomes of primary PCI at a large tertiary care center in India. Settings and Design: A prospective cohort of patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI was enrolled between December 2015 and November 2016. Subjects and Methods: The demographic profile, risk factors, clinical characteristics, inhospital complications, and outcomes at 30 days were assessed. The primary outcome was a composite of death, reinfarction, and repeat revascularization. Acute left ventricular failure (LVF), complete heart block (CHB) or bradyarrhythmia, ventricular tachycardia (VT) or ventricular fibrillation, stroke, and major thrombolysis in myocardial infarction bleeding were the inhospital complications that were considered the secondary outcomes. Results: A total of 237 STEMI patients with primary PCI were enrolled, accounting for 7.5% of all PCI procedures performed during this period. The mean age was 55.4 ± 11.9 years, and 86.5% were male. The mean window period was 5.1 ± 3.18 h, and the mean door-to-balloon time was 58.4 ± 11.5 min. Prior to PCI, the most often administered antiplatelets were clopidogrel in 54.4% of patients and prasugrel in 55.6%. The aspiration thrombectomy was done in 70.8% of patients. Predilatation with balloon was required in 41.8% of patients. Drug-eluting stents were implanted in 98.3% of patients. The primary outcome was found in 3.3% of patients (deaths – 2.9% and reinfarction – 0.4%) and the secondary outcomes were observed in 13%. The common inhospital complication was CHB or bradyarrhythmia in 5.0% followed by acute LVF in 4.6% and then VT in 2.1%. Conclusions: The primary outcome rate is as good as reported in developed Western countries in contemporary treatment practices of STEMI. CHB and acute LVF were the major inhospital complications among patients of STEMI treated with primary PCI.
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来源期刊
Research in Cardiovascular Medicine
Research in Cardiovascular Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
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