70岁以上中危非ST段抬高型ACS患者不同时间窗介入干预的疗效

发布时间：2018-05-22 07:31

  本文选题：老年 + 非ST段抬高急性冠状动脉综合征　； 参考：《临床心血管病杂志》2017年04期

【摘要】：目的:观察老年中危非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者不同介入治疗时机的临床预后。方法:本研究为回顾性研究,按照2015年欧洲NSTE-ACS管理指南评判中危NSTE-ACS风险标准,连续纳入本院2010-01-2013-06成功行经皮冠状动脉介入(PCI)治疗的老年中危NSTE-ACS患者599例,根据入院后不同介入治疗时间分为入院后24h内介入组(195例)、24~72h内介入组(234例)和72h后介入组(170例)。主要临床终点为PCI术后3年随访期间包括心性死亡和心肌梗死、靶血管血运重建(TVR)在内的主要心血管不良事件(MACE)的发生情况。结果:入院后24h内介入组、24~72h介入组、72h后介入组3年MACE的发生率分别是11.4%、9.5%和23.7%(P=0.001),进一步利用多因素Cox回归分析显示24h内介入组患者MACE的发生率低于72h后介入组(OR:0.645,95%CI:0.437~0.963,P=0.021),24~72h介入组患者MACE的发生率低于72h后介入组(OR:0.372,95%CI:0.217~0.637,P=0.001),而24~72h介入组MACE的发生率与24h内介入组未见明显差异(OR:0.712,95%CI:0.386~1.313,P=0.276)。结论:对于老年中危NSTE-ACS患者,入院后72h内较72h后干预可以减少患者MACE的发生率。
[Abstract]:Objective: To observe the clinical prognosis of different intervention treatments in elderly patients with non ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: This study was a retrospective study. According to the European NSTE-ACS management guidelines in 2015 to evaluate the risk of intermediate risk NSTE-ACS, percutaneous coronary intervention was performed successfully in 2010-01-2013-06 in our hospital. PCI) 599 elderly patients with middle risk NSTE-ACS were divided into 24h internal intervention group (195 cases) after admission, 24~72h internal intervention group (234 cases) and post 72h intervention group (170 cases). The main clinical endpoint was cardiac death and myocardial infarction, and target vascular revascularization (TVR) during the 3 year follow-up of PCI operation. The occurrence of cardiovascular adverse events (MACE). Results: the incidence of MACE in 3 years after admission to 24h was 11.4%, 9.5% and 23.7% (P=0.001), respectively. The incidence of MACE in the patients with 24h intervention group was lower than that of 72h after the intervention group (OR:0.645,95%CI:0.437~0.963, P=0.0). 21) the incidence of MACE in the 24~72h intervention group was lower than that of the 72h after the intervention group (OR:0.372,95%CI:0.217~0.637, P=0.001), but the incidence of MACE in the 24~72h intervention group was not significantly different from that in the 24h intervention group (OR:0.712,95%CI:0.386~1.313, P=0.276). Conclusion: for the elderly patients with middle risk, the intervention in 72h after admission can reduce the incidence of the patients. The rate of occurrence.
【作者单位】： 安徽省立医院心血管内科;
【基金】：安徽省公益性技术应用研究联动计划(No:15011d04032) 安徽省科技攻关计划(No:1604a0802074)
【分类号】：R541.4

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