赵霄潇,王莹,刘臣,周鹏,盛照雪,李健楠,周金英,陈润真,陈艺,宋莉,赵汉军,颜红兵

• 1:国家心血管病中心北京协和医学院中国医学科学院阜外医院冠心病中心
• 2:国家心血管病中心中国医学科学院阜外医院深圳医院冠心病中心

摘要(Abstract)：

目的探讨对于行急诊经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者,从症状开始至球囊扩张(O-to-B)时间和死亡率之间的相关性。方法纳入自2010年1月至2018年7月中国医学科学院阜外医院行急诊PCI手术的STEMI患者的临床资料,符合入组和排除标准的共计3348例。结果在平均随访约3年的研究中,死亡人数共计192例(5.7%),有258例(7.7%)发生主要不良心血管事件(MACE),另有60例(1.8%)患者发生卒中事件。相关性研究表明,O-to-B时间与室壁瘤发病率(r=0.041,P=0.022)、心肌梗死溶栓治疗试验(TIMI)血流分级(r=0.110,P<0.001)、MACE发病率(r=0.046,P=0.010)和全因死亡率(r=0.061,P<0.001)呈显著正相关。受试者工作特征曲线(ROC)表明,与单纯的GRACE评分[曲线下面积(AUC)=0.681]相比,O-to-B时间联合GRACE评分作为共同预测因子,对死亡率的预测价值更高(AUC=0.699)。另外,随着O-to-B时间的延长,死亡率的累积发生率增加(P<0.05)。结论较短的O-to-B时间与行急诊PCI的STEMI患者良好的预后存在显著相关性。

关键词(KeyWords)： 症状开始至球囊扩张时间;急诊经皮冠状动脉介入治疗;ST段抬高型心肌梗死;死亡率

Abstract:

Keywords:

基金项目(Foundation): 中国医学科学院医学与健康科技创新工程项目(2016-I2M-1-009)

作者(Author): 赵霄潇,王莹,刘臣,周鹏,盛照雪,李健楠,周金英,陈润真,陈艺,宋莉,赵汉军,颜红兵

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