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分叉病变对急性心肌梗死急诊介入治疗效果的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第4期
页码:
507
栏目:
临床研究
出版日期:
2011-08-25

文章信息/Info

Title:
Impact of bifurcated lesions on prognosis of emergency percutaneous coronary intervention in patients with acute myocardial infarction
作者:
李东宝1; 华琦2; 刘志2; 李虹伟1; 陈晖1
首都医科大学：1.附属北京友谊医院心内科,北京 100050，2.宣武医院心脏科,北京 100053
Author(s):
LI Dong-bao1;  HUA Qi2;  LIU Zhi2;  LI Hong-wei1;  CHEN Hui1
1.Department of Cardiology, Beijing Friendship Hospital, Beijing 100050, China, 2.Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
关键词:
分叉病变; 心肌梗死; 急性; 经皮冠脉介入治疗
Keywords:
bifurcated lesion;  percutaneous coronary intervention;  acute myocardial infarction
分类号:
R541.4
DOI:
61-1268/R.20110503.1636.022
文献标识码:
A
摘要:
目的:探讨分叉病变对ST段抬高型急性心肌梗死（STEMI）患者急诊冠脉介入治疗（PCI）效果的影响。方法： 318例连续入选的STEMI患者在发病12 h内行PCI，根据冠脉造影提示是否为分叉病变分为分叉组（n=92）和非分叉组(n=226)。结果： 分叉组PCI的成功率为86％，与非分叉组(84%)相比无显著差异。两组30 d主要不良事件也无统计学差异(分叉组与非分叉组：6% vs. 7%)。结论： STEMI患者急诊PCI治疗分叉病变的即刻和近期疗效与无分叉病变相近。
Abstract:
AIM:To investigate the impact of bifurcated lesions on the short-term prognosis after percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarction (AMI). METHODS: A total of 318 consecutive AMI patients treated with primary PCI within 12 h of symptom onset were divided into bifurcated group (n=92) and non-bifurcated group (n=226) based on the cineangiogram performed during PCI. RESULTS: Bifurcated lesions on angiography were found in 28.9% of the patients and predominantly involved the left anterior descending artery. In the bifurcated group, double guidewire protection, one stent plus “kissing balloon” techniques and provisional T-stenting were used, respectively, in 46%, 36% and 10% of the patients. The procedural success rate was 86% for the main artery bifurcation compared with 84% for the nonbifurcated lesion (P=0.89). No significant difference was observed in the 30-day major adverse event rates between groups (6% of bifurcated group vs. 7% of non-bifurcated group, P=0.86). CONCLUSION: In patients with ST segment elevation, AMI, immediate and short-term prognoses of PCI are similar for bifurcated and nonbifurcated lesion.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-10-11.通讯作者：华琦，教授，主要从事高血压病、冠心病的研究Email:huaqi5371@medmail.com.cn 作者简介：李东宝，副主任医师Email:leetobo@sina.com 共同第一作者：刘志，博士生Email:liuzhi7742@sina.com
更新日期/Last Update: 2011-06-02