Rasoul Saman, Ottervanger Jan Paul, de Boer Menko-Jan, Dambrink Jan-Henk E, Hoorntje Jan C A, Gosselink A T Marcel, Zijlstra Felix, Suryapranata Harry, van 't Hof Arnoud W J
Isala Klinieken, Department of Cardiology, Zwolle, The Netherlands.
Int J Cardiol. 2009 May 1;134(1):104-9. doi: 10.1016/j.ijcard.2008.01.041. Epub 2008 May 27.
More than 10 years ago, survival benefit of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) was demonstrated in several randomized trials. Since then, primary PCI has been implemented in routine daily practice and is in the guidelines of the preferred reperfusion therapy for patients with STEMI. We aimed to assess time-dependent changes in baseline characteristics, concomitant treatment and prognosis in patients with STEMI treated with primary PCI.
Individual patient data from all 4732 patients admitted for primary PCI for STEMI between 1994 and 2004 in our hospital were recorded. Patient characteristics, concomitant treatment and one-year outcome were evaluated.
During the 11-year period, mean age and proportion of female were increasing, whereas door to balloon time decreased. Stent implantation rates increased from 2% to 84%. At discharge, prescription of aspirin, beta-blockers, statins, and ADP receptor blockers increased significantly. From 1994 to 2004, hospital stay shortened from 10.4 to 4.5 days p<0.001. Hospital and one-year mortality decreased, from 6.7% to 1.4% and 9% to 4.9% (both p<0.001), respectively.
Between 1994 and 2004, utilization of stents and recommended pharmacotherapies increased remarkably. Hospital stay and both hospital and one-year mortality decreased significantly.
十多年前，多项随机试验证实了直接经皮冠状动脉介入治疗（PCI）对ST段抬高型心肌梗死（STEMI）患者的生存获益。自那时起，直接PCI已应用于日常临床实践，并成为STEMI患者首选再灌注治疗的指南推荐。我们旨在评估接受直接PCI治疗的STEMI患者基线特征、伴随治疗及预后的时间依赖性变化。
记录了1994年至2004年间我院收治的4732例因STEMI接受直接PCI治疗患者的个体数据。对患者特征、伴随治疗及一年结局进行了评估。
在这11年期间，平均年龄和女性比例增加，而门球时间缩短。支架植入率从2%增至84%。出院时，阿司匹林、β受体阻滞剂、他汀类药物及ADP受体阻滞剂的处方显著增加。1994年至2004年，住院时间从10.4天缩短至4.5天（p<0.001）。住院死亡率和一年死亡率均下降，分别从6.7%降至1.4%以及从9%降至4.9%（均p<0.001）。
1994年至2004年间，支架及推荐药物治疗的应用显著增加。住院时间以及住院死亡率和一年死亡率均显著下降。
