非ST段抬高型急性冠状动脉综合征患者侵入性治疗策略的优化
[Optimization of Invasive Treatment Strategy in Patients With Non-ST Elevation Acute Coronary Syndrome].
作者信息
Prilutskaya Y A, Dvoretsky L I
机构信息
City Clinical Hospital named after S. S. Yudin, Moscow.
Federal State Budgetary Educational Institution of Higher Education "I. M. Sechenov First Moscow State Medical University" of the Ministry of Health of the Russian Federation.
出版信息
Kardiologiia. 2018 Jan(1):5-10. doi: 10.18087/cardio.2018.1.10077.
OBJECTIVE
to compare strategies of invasive treatment of patients with non-ST elevation acute coronary syndrome (NSTEACS) hospitalized in 2014 and 2015.
MATERIALS AND METHODS
We have analyzed treatment strategy used in patients with NSTEACS hospitalized in cardio-reanimation department of a city hospital during one month in two successive years (January 2014 and November 2015). We have compared indications to, and timing of coronary angiography, numbers of performed percutaneous coronary interventions (PCI) and coronary artery bypass grafting surgeries.
RESULTS
Portion of patients subjected to invasive procedures in 2014 was 26 %, in 2015-42 %. All 32 primary procedures were PCIs. An increase was due to delayed interventions (24-72 hours), which were not performed in 2014. We also more often used selective multivessel coronary stenting, what facilitated availability of invasive treatment for elderly patients. Hospital mortality of patients with NSTEACS decreased from 16 to 7 %.
目的
比较2014年和2015年住院的非ST段抬高型急性冠状动脉综合征（NSTEACS）患者的侵入性治疗策略。
材料与方法
我们分析了连续两年（2014年1月和2015年11月）某城市医院心脏复苏科收治的NSTEACS患者在一个月内采用的治疗策略。我们比较了冠状动脉造影的指征和时机、经皮冠状动脉介入治疗（PCI）的数量以及冠状动脉旁路移植手术的数量。
结果
2014年接受侵入性治疗的患者比例为26%，2015年为42%。所有32例主要手术均为PCI。增加的原因是延迟干预（24 - 72小时），2014年未进行此类干预。我们也更频繁地使用选择性多支冠状动脉支架置入术，这有助于老年患者获得侵入性治疗。NSTEACS患者的医院死亡率从16%降至7%。
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