Department of Cardiology, Thorax Center, University Medical Center Groningen, Groningen; currently: Department of Cardiology, Isala Klinieken, Zwolle, the Netherlands.
Neth Heart J. 2010 Mar;18(3):122-8. doi: 10.1007/BF03091750.
Background. We investigated the association between clinical characteristics, angiographic data and ventricular arrhythmia in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI)Methods. In patients with STEMI (n=225), a Holter analysis was performed the first 12 hours after primary PCI.Results. A total of 151 (66%) patients had >/=1 episode of ventricular tachycardia (VT). Age <70 years (RR 4.9, 95% CI 1.8 to 12.7), TIMI 0-1 pre-PCI (RR 2.6, 95% CI 1.1 to 6.1) and peak CK (RR 3.5, 95% CI 1.9 to 5.8) were independent predictors of VT. One-year mortality was 7%, no association between mortality and presence of early VT was found.Conclusion. Ventricular tachycardia is common in the first 12 hours after primary PCI for STEMI. Independent predictors of VT are younger age, TIMI 0-1 flow prior to PCI and larger infarct size. The presence of early VT was not significantly associated with one-year mortality. (Neth Heart J 2010;18:122-8.).
背景。我们研究了 ST 段抬高型心肌梗死(STEMI)患者行直接经皮冠状动脉介入治疗(PCI)后临床特征、血管造影数据与室性心律失常之间的相关性。
方法。在 STEMI 患者(n=225)中,在直接 PCI 后 12 小时内进行了动态心电图分析。
结果。共有 151 例(66%)患者发生了≥1 次室性心动过速(VT)。年龄<70 岁(RR 4.9,95%CI 1.8 至 12.7)、PCI 术前 TIMI 0-1 级(RR 2.6,95%CI 1.1 至 6.1)和肌酸激酶峰值(RR 3.5,95%CI 1.9 至 5.8)是 VT 的独立预测因子。1 年死亡率为 7%,VT 与死亡率之间无显著相关性。
结论。STEMI 患者直接 PCI 后 12 小时内 VT 很常见。VT 的独立预测因子是年龄较小、PCI 术前 TIMI 血流 0-1 级和梗死面积较大。早期 VT 的存在与 1 年死亡率无显著相关性。