早期介入治疗对高危非ST段抬高型急性冠状动脉综合征患者12个月临床结果的影响Eff ect of early intervention on 12-month follow-up clinical prognosis in patients with high-risk nonST-segment elevation acute coronary syndrome
徐承义,刘心甜,刘成伟,吴明祥,苏晞,彭剑,宋丹,汪敏,鄢华,蔡建华
摘要(Abstract):
目的比较早期经皮冠状动脉介入(PCI)与延迟PCI策略对高危非ST段抬高型急性冠状动脉综合征(NSTE-ACS)12个月临床终点的影响。方法连续收集自2015年1月1日至2015年12月31日在武汉亚洲心脏病医院行PCI治疗的高危NSTE-ACS患者758例,并依据介入治疗时间窗分为早期PCI组(确诊后24 h内PCI,185例)和延迟PCI组(确诊后超过24 h PCI,573例),主要终点是术后12个月主要不良心血管事件(MACE),包括全因死亡与再发非致死性心肌梗死。回顾性对比分析两组基线临床资料、冠状动脉影像特征、PCI相关数据以及主要终点。结果 711例(93.8%)患者完成12个月随访。早期PCI组主要终点MACE发生率与延迟PCI组比较差异无统计学意义(14.5%比11.2%,χ~2=1.289,P=0.256),全因死亡与再发非致死性心肌梗死两组比较,差异均无统计学意义(均P>0.05)。早期PCI组显著降低住院时间[(7.6±3.1)d比(10.7±3.8)d,t=2.489,P=0.014)]及减少医疗费用[(4.85±1.35)万元比(5.28±1.64)万元,t=2.132,P=0.038)]与延迟PCI组比较,差异均有统计学意义。结论早期介入干预不能降低高危NSTE-ACS患者PCI术后12个月MACE发生率,但能缩短住院时间,减少医疗费用。
关键词(KeyWords): 早期介入策略;非ST段抬高型急性冠状动脉综合征;高危
基金项目(Foundation): 武汉市科委课题项目(WX15C02)
作者(Author): 徐承义,刘心甜,刘成伟,吴明祥,苏晞,彭剑,宋丹,汪敏,鄢华,蔡建华
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