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AHJ：额外血运重建对多支血管病变STEMI患者的死亡率影响

2016-02-25 [db:作者] 中国心血管杂志

额外血运重建多支血管病变STEMI
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Influence of multivessel disease with or without additional revascularization on mortality in patients with ST-segment elevation myocardial infarction

对ST段抬高型心肌梗死(STEMI)患者进行及时的急诊血运重建术是公认的治疗方法。对多支血管病变的STEMI患者，只处理罪犯血管是否绝对正确尚不明确。

故本研究者对比了：
(1)单支病变的STEMI患者和多支病变的STEMI患者；
(2)在急诊PCI术后两个月内对非罪犯血管进行或不进行血运重建术的患者。

他们纳入了丹麦西部心脏注册研究2002年1月至2009年6月间进行了急诊PCI的STEMI患者，共300万人。用Cox回归模型估算死亡的危害比(HR)，以控制潜在的混淆因素。

研究共纳入8822例患者：4770例(54.1%)为单支病变，4052例(45.9%)为多支病变。1年累计总死亡率为7.6%，7年累计死亡率为24.0%。其中，多支病变患者的7年死亡率高[校正HR：1.45(95%CI：1.30~1.62), P<0.001]。在多支病变患者中，不进行非罪犯病变血运重建者的7年死亡率高[校正HR：1.50(95%CI：1.25~1.80)，P<0.001]。非罪犯血管进行血运重建术者的7年死亡率较低[校正HR：1.01(95%CI：0.84~1.22)，P=0.89]，与单支病变患者相似。

由此可见，STEMI合并多支病变者的死亡率比单支病变高。在多支病变STEMI患者中，对非罪犯血管也进行血运重建术比只对罪犯血管进行PCI术生存率更高。

原始出处：
Jensen LO, Terkelsen CJ, Horváth-Puhó E, Tilsted HH, Maeng M, Junker A, Lassen JF, Thuesen L, Sørensen HT, Thayssen P. Influence of multivessel disease with or without additional revascularization on mortality in patients with ST-segment elevation myocardial infarction. Am Heart J, 2015, 170(1): 70-78. PMID: 26093866
                   

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    2016-05-18 Luyuxie_17

    #血管病#

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    2016-12-04 宋威

    #多支血管#

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    2016-09-13 12498c32m68暂无昵称

    #STEMI患者#

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    2016-02-26 124987c6m36暂无昵称

    #血管病变#

    0

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    2016-02-26 12498bb3m92(暂无昵称)

    #STEM#

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