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[急性心肌梗死中的血管成形术。早期和晚期结果]

[Angioplasty in acute myocardial infarction. Early and late results].

作者信息

Ugalde H, Ramírez A, Benavente D, Antúnez M, García S, Dussaillant G, Ayala F, Silva A M, Farías E, Villegas R

机构信息

Laboratorio Hemodinamia, Hospital Clínico Universidad de Chile.

出版信息

Rev Med Chil. 1999 May;127(5):565-75.

Abstract

BACKGROUND

The usefulness of angioplasty in the first hours of an acute myocardial infarction is widely demonstrated. However, its long term effects are less well known.

AIM

To report the effects of coronary angioplasty on early and late outcome of patients with acute myocardial infarction.

PATIENTS AND METHODS

A non-randomized, consecutive and retrospective analysis of the hospital and late outcome of 70 patients, aged 35 to 85 years, subjected to coronary angioplasty during an acute myocardial infarction. Patients were followed during 12 to 60 months.

RESULTS

Angioplasty was performed 5.3 +/- 5 hours after the initial symptoms. Anterior descendent artery was occluded in 63% of patients with a 99.5% luminal occlusion and TIMI 0-1 anterograde flow. An angiographic success was achieved in 83% of procedures with a residual stenosis of 32.3%. Recurrent ischemia was observed in 6% of patients, that were treated with a new revascularization procedure. Thirteen percent of patients died, all due to cardiogenic shock. Severe ventricular failure and failure of revascularization influenced mortality. During the first year of follow up there was a 3.3% mortality and 3.3% of patients required a new revascularization procedure. Eighty percent of patients were asymptomatic and event-free.

CONCLUSION

Angioplasty was a useful therapeutic procedure in this group of patients.

摘要

背景

血管成形术在急性心肌梗死最初数小时内的有效性已得到广泛证实。然而,其长期效果却鲜为人知。

目的

报告冠状动脉血管成形术对急性心肌梗死患者早期和晚期结局的影响。

患者与方法

对70例年龄在35至85岁之间、在急性心肌梗死期间接受冠状动脉血管成形术的患者的住院及晚期结局进行非随机、连续和回顾性分析。对患者进行了12至60个月的随访。

结果

血管成形术在初始症状出现后5.3±5小时进行。63%的患者前降支动脉闭塞,管腔闭塞率为99.5%,TIMI 0 - 1级顺行血流。83%的手术获得血管造影成功,残余狭窄率为32.3%。6%的患者出现复发性缺血,这些患者接受了新的血运重建手术。13%的患者死亡,均死于心源性休克。严重的心力衰竭和血运重建失败影响死亡率。在随访的第一年,死亡率为3.3%,3.3%的患者需要进行新的血运重建手术。80%的患者无症状且无事件发生。

结论

血管成形术对该组患者是一种有效的治疗方法。

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