Dubey Laxman, Bhattacharya Rabindra, Guruprasad Sogunuu, Subramanyam Gangapatnam
College of Medical Sciences and Teaching Hospital, Department of Cardiology, Chitwan, Nepal.
Maedica (Bucur). 2013 Jun;8(2):103-7.
Primary percutaneous coronary intervention represents one of the cornerstone management modalities for patients with acute ST-elevation myocardial infarction and has undergone tremendous growth over the past two decades. This study was aimed to determine the early clinical outcomes of primary percutaneous coronary interventions in a tertiary-level teaching hospital without onsite cardiac surgery backup.
This was a prospective descriptive study which included all consecutive patients who were admitted for primary percutaneous coronary interventions between March 2011 and January 2013 at the College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal. Total 68 patients underwent primary percutaneous coronary interventions as a mode of revascularization. The primary end point of the study was to identify in-hospital as well as 30-day clinical outcomes of primary percutaneous coronary interventions.
The mean age was 56.31 ± 11.47 years, with age range of 32 years to 91 years. Of the 68 primary percutaneous coronary interventions performed, 15 (22.05%) were carried out in women and 10 (14.70%) in patients over 75 years of age. Primary percutaneous coronary intervention for anterior wall myocardial infarction was more common than for non-anterior wall myocardial infarction (55.88% vs. 44.12%). Proximal artery stenting was performed in 38.50% and the non proximal artery stenting in 61.50%. The outcomes were mortality (5.88%), cardiogenic shock (5.88%), contrast-induced nephropathy requiring dialysis (2.94%), arrhythmias requiring treatment (4.41%), early stent thrombosis (2.94%) and minor complications (14.70%).
Primary percutaneous coronary intervention improves the early clinical outcomes in patient with acute ST-elevation myocardial infarction. Despite having no onsite cardiac surgery backup, primary percutaneous coronary intervention was feasible with acceptable complications in a tertiary-care teaching hospital.
直接经皮冠状动脉介入治疗是急性ST段抬高型心肌梗死患者的基石性治疗方式之一，在过去二十年中得到了巨大发展。本研究旨在确定在一家没有现场心脏外科支持的三级教学医院中进行直接经皮冠状动脉介入治疗的早期临床结果。
这是一项前瞻性描述性研究，纳入了2011年3月至2013年1月在尼泊尔巴拉特普尔医学科学与教学医院因直接经皮冠状动脉介入治疗而入院的所有连续患者。共有68例患者接受了直接经皮冠状动脉介入治疗作为血管重建的方式。本研究的主要终点是确定直接经皮冠状动脉介入治疗的院内及30天临床结果。
平均年龄为56.31±11.47岁，年龄范围为32岁至91岁。在进行的68例直接经皮冠状动脉介入治疗中，15例（22.05%）为女性，10例（14.70%）为75岁以上患者。前壁心肌梗死的直接经皮冠状动脉介入治疗比非前壁心肌梗死更常见（55.88%对44.12%）。近端动脉支架置入术占38.50%，非近端动脉支架置入术占61.50%。结果包括死亡率（5.88%）、心源性休克（5.88%）、需要透析的造影剂诱发肾病（2.94%）、需要治疗的心律失常（4.41%）、早期支架血栓形成（2.94%）和轻微并发症（14.70%）。
直接经皮冠状动脉介入治疗可改善急性ST段抬高型心肌梗死患者的早期临床结果。尽管没有现场心脏外科支持，但在三级护理教学医院中，直接经皮冠状动脉介入治疗是可行的，并发症可接受。
