Jinnouchi Hiroyuki, Sakakura Kenichi, Wada Hiroshi, Kubo Norifumi, Sugawara Yoshitaka, Nakamura Tomohiro, Funayama Hiroshi, Ako Junya, Momomura Shin-ichi
Division of Cardiovascular Medicine, Department of Integrated Medicine I, Jichi Medical University, Saitama Medical Center, Japan.
Int Heart J. 2012;53(2):79-84. doi: 10.1536/ihj.53.79.
Transradial percutaneous coronary intervention (PCI), which is less invasive than transfemoral PCI, may facilitate early rehabilitation of patients with acute myocardial infarction (AMI). The aim of our study was to investigate whether transradial PCI is associated with a shorter coronary care unit (CCU) stay in very elderly AMI patients (≥ 80 years old). We enrolled 116 AMI patients aged ≥ 80 years. There were 39 patients in the transradial group and 77 patients in the non-transradial group. The length of CCU stay, the length of hospital stay, in-hospital mortality, the day of the monitored sitting and standing test, and the occurrence of delirium were compared between the two groups. The duration of CCU stay in the transradial and non-transradial groups was 3.6 ± 1.5 days and 5.0 ± 3.2 days, respectively (P = 0.001). The duration of hospital stay in the transradial and non-transradial groups was 13.3 ± 7.4 days and 19.2 ± 11.1 days, respectively (P = 0.001). In-hospital mortality was not different between the two groups (7.7% versus 2.6%, P = 0.20). The day of the monitored standing test in the transradial and non-transradial groups was 3.2 ± 0.7 and 4.6 ± 2.3, respectively (P < 0.0001). Multivariate logistic regression analysis identified a transradial approach as an independent predictor of short (≤ 3 days) CCU stay (OR: 3.01, 95%CI: 1.16-7.83, P = 0.02). In conclusion, transradial PCI was associated with a shorter CCU stay in AMI patients ≥ 80 years old. Furthermore, transradial PCI facilitated early rehabilitation in this high risk population.
经桡动脉冠状动脉介入治疗（PCI）比经股动脉PCI侵入性更小，可能有助于急性心肌梗死（AMI）患者的早期康复。我们研究的目的是调查经桡动脉PCI是否与高龄AMI患者（≥80岁）在冠心病监护病房（CCU）的住院时间缩短有关。我们纳入了116例年龄≥80岁的AMI患者。经桡动脉组有39例患者，非经桡动脉组有77例患者。比较了两组患者在CCU的住院时间、住院时间、院内死亡率、监测坐立试验的天数以及谵妄的发生情况。经桡动脉组和非经桡动脉组在CCU的住院时间分别为3.6±1.5天和5.0±3.2天（P=0.001）。经桡动脉组和非经桡动脉组的住院时间分别为13.3±7.4天和19.2±11.1天（P=0.001）。两组的院内死亡率无差异（7.7%对2.6%，P=0.20）。经桡动脉组和非经桡动脉组监测站立试验的天数分别为3.2±0.7天和4.6±2.3天（P<0.0001）。多因素逻辑回归分析确定经桡动脉途径是CCU短期（≤3天）住院的独立预测因素（OR：3.01，95%CI：1.16-7.83，P=0.02）。总之，经桡动脉PCI与80岁及以上AMI患者在CCU的住院时间缩短有关。此外，经桡动脉PCI促进了这一高危人群的早期康复。
