超過(guò)再灌注治療時(shí)間窗的stemi患者的介入治療策略選擇(參考版)
2024-10-02 09:35本頁(yè)面
【正文】 Epub ahead of print. 30Day Outes Primary PCI (n = 1,763) Pharmaco Invasive (n = 692) P Value Mortality % % Recurrent Ischemia/MI % % TIMI Major Bleeding % % European Heart Journal (2020) 31, 2501–2555 從癥狀開(kāi)始起 1224小時(shí)，甚至可能至 60小時(shí)的病人，即使疼痛緩解，血流動(dòng)力學(xué)穩(wěn)定，也有可能從早期冠脈造影及可能的 PCI中獲益。= 11 % 20 % p= (321) (735) (n=248) Symptom duration (h) Total occlusion subgroup: Infarct size Infarct size (% of LV) Symptomvarighed (t) Salvage / AAR (%) 57 % 44 % p= (4286) (2373) Linear regression: p= R178。= (n=262) Salvage / AAR (%) Symptomvarighed (t) Symptom duration (h) Symptomvarighed (t) Infarktst248。= 6 % 14 % p= (117) (330) (n=415) Symptom duration (h) Infarct size (% of LV) Area at risk 25 % 31 % p= (1539) (2245) Linear regression: p= R178。 10 Diabetes (%) 9 4 Hypertension (%) 32 31 Hypercholesterolaemia (%) 19 9 Previous AMI (%) 7 0 * Median BMI (kg / m178。 TnT μg/l Inclusion criteria ? PCI within previous 30 days ? Previous CABG ? Left main stenosis ? Peak troponin T μg/l ? Risk area 5% of LV ? Reinfarction, rePCI or CABG during followup ? Thrombectomy Exclusion criteria Consent, n=619 Inclusion, n=415 Exclusion, n=204 ? By criteria, n=152 ? No final scintigraphy, n=52 (6 deaths) 12 hours, n=360 1272 hours, n=55 Patient inclusion 12 h (n=360) 1272 h (n=55) p Women (%) 25 33 Age (y) 62177。 10%: n=200 1272 h: Infarct size = 20177。 2) Burns RJ, JACC 2020。152:11331139 ? Salvage index (% of risk area salvaged): Primary PCI vs. Medical therapy: p Background 44% 23% ? To evaluate if the 12hour limit is a relevant cutoff point for offering primary angioplasty Aim ? Late presenters (1272 h) do not achieve myocardial salvage after primary angioplasty and therefore develop larger final infarct sizes than early presenters (12 h) Hypothesis ? Symptom duration was defined as time from onset of symptoms to first ballo
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