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急性心肌梗死患者中溶栓与后续经皮冠状动脉介入治疗的关系——基于溶栓及后续腔内血管成形术试验的分析——

Relationship between the generation and the facilitated percutaneous coronary intervention in patients with acute myocardial infarction--analysis based on the fibrinolysis and subsequent transluminal trial--.

作者信息

Watanabe Ikuyoshi, Nagao Ken, Tani Shigemasa, Ohba Tomiya, Arima Ken, Ohiwa Kouji, Masuda Naoki, Anazawa Takeo, Kanmatsuse Katsuo, Kushiro Toshio

机构信息

Division of Cardiovascular Medicine, Surugadai Nihon University Hospital, Chiyoda-ku, Tokyo, Japan.

出版信息

Circ J. 2004 Dec;68(12):1117-22. doi: 10.1253/circj.68.1117.

Abstract

BACKGROUND

The purpose of the present study was to evaluate the efficacy and safety of facilitated percutaneous coronary intervention (PCI) in comparing young and elderly patients with acute myocardial infarction.

METHODS AND RESULTS

The present study enrolled 168 initial myocardial infarction patients within 12 h of the symptom onset between 40 and 80 years of age who were indicated on the fibrinolysis and subsequent transluminal (FAST-3) trial. The patients were divided into 4 groups according to their age, peak creatine kinase (CK), peak CK-MB and peak troponin T (Tn-T) levels, and cardiac function were compared between the 4 groups. There were no differences between the 4 groups in terms of the time from arrival at the emergency room (ER) to the achievement of TIMI-3 patency. There were also no significant differences between the 4 groups in terms of the peak CK, peak CK-MB or peak Tn-T levels. Furthermore, there were no significant differences between the 4 groups in terms of the mortality rate or the incidence of hemorrhagic complications at 30 days.

CONCLUSIONS

Facilitated PCI is considered to have an important potential role in the treatment of myocardial infarction in Japan, in which the age of the population is steadily increasing.

摘要

背景

本研究旨在评估在急性心肌梗死的年轻和老年患者中,易化经皮冠状动脉介入治疗(PCI)的疗效和安全性。

方法与结果

本研究纳入了168例年龄在40至80岁之间、症状发作12小时内的首次心肌梗死患者,这些患者入选了溶栓及随后的腔内治疗(FAST-3)试验。根据患者年龄、肌酸激酶(CK)峰值、CK-MB峰值和肌钙蛋白T(Tn-T)峰值水平将患者分为4组,并比较4组之间的心脏功能。4组从到达急诊室(ER)到实现TIMI-3血流灌注的时间无差异。4组的CK峰值、CK-MB峰值或Tn-T峰值水平也无显著差异。此外,4组在30天时的死亡率或出血并发症发生率方面也无显著差异。

结论

在日本人口年龄不断增长的情况下,易化PCI被认为在心肌梗死治疗中具有重要的潜在作用。

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