Cardiology Department, Ospedale Moriggia Pelascini, Italia Hospital, Gravedona, Italy.
J Cardiovasc Med (Hagerstown). 2011 Jan;12(1):43-50. doi: 10.2459/JCM.0b013e328340334d.
Percutaneous coronary intervention (PCI) has been shown to be the best reperfusion therapy for acute myocardial infarction with ST-elevation (STEMI), but data from registries show differences in patient populations and outcomes between randomized trials and real life.
We sought to provide information about the current status of this treatment with a registry collecting data in Lombardy, the most densely populated region in Italy, with widespread availability of cathlabs and a well-established network for the treatment of STEMI.
Patient enrollment was performed by 32 hub centres recruiting 3901 STEMI patients who underwent PCI procedures within 12 h of the onset of symptoms, of whom 3317 patients underwent primary PCI, 376 'facilitated' PCI, and 208 rescue PCI in cathlabs located, in 77% of cases, in the same hospital of admission. In-hospital and 30-day total death were 4.4 and 6.6%, respectively. At multivariate analysis independent negative predictors of 30-day mortality were Killip class 3-4, number of involved ECG leads, chronic renal failure and age, whereas positive predictors were ST resolution more than 50% and postprocedural grade 3 thrombolysis in myocardial infarction flow.
LombardIMA PCI registry enrolled STEMI patients representing a real-world population treated with PCI. Findings presented in this study may provide a benchmark for similar registries undertaken in other Italian regions and may be helpful to assess future possible developments of care for STEMI patients.
经皮冠状动脉介入治疗（PCI）已被证明是治疗 ST 段抬高型急性心肌梗死（STEMI）的最佳再灌注治疗方法，但注册研究的数据显示，随机试验和真实世界之间的患者人群和结局存在差异。
我们旨在通过收集意大利人口最稠密的伦巴第地区数据的注册研究，提供关于这种治疗方法的最新信息。该地区有广泛的导管室可用性和完善的 STEMI 治疗网络。
32 个中心进行了患者入组，共招募了 3901 例 STEMI 患者，这些患者在症状出现后 12 小时内接受了 PCI 治疗，其中 3317 例患者接受了直接 PCI，376 例患者接受了辅助 PCI，208 例患者在导管室进行了挽救性 PCI，77%的情况下导管室位于入院医院。院内和 30 天总死亡率分别为 4.4%和 6.6%。多变量分析显示，30 天死亡率的独立负预测因素为 Killip 分级 3-4 级、心电图导联受累数量、慢性肾功能衰竭和年龄，而正预测因素为 ST 段回落>50%和术后心肌梗死溶栓分级 3 级血流。
伦巴第 IMA PCI 注册研究纳入了代表真实世界人群的 STEMI 患者，他们接受了 PCI 治疗。本研究中的结果可为意大利其他地区进行的类似注册研究提供基准，并有助于评估未来 STEMI 患者治疗的可能发展。
