药物洗脱支架（DES）与裸金属支架（BMS）治疗ST段抬高型心肌梗死（STEMI）的比较：在第二代DES时代，哪些患者接受了BMS治疗？
Comparison of drug eluting stents (DESs) and bare metal stents (BMSs) with STEMI: who received BMS in the era of 2nd generation DES?
作者信息
Doshi Rajkumar, Shah Jay, Jauhar Varun, Decter Dean, Jauhar Rajiv, Meraj Perwaiz
机构信息
Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York.
Department of Internal Medicine, Mercy Saint Vincent Hospital, University of Toledo, Toledo, OH.
出版信息
Heart Lung. 2018 May-Jun;47(3):231-236. doi: 10.1016/j.hrtlng.2018.02.004. Epub 2018 Mar 12.
BACKGROUND
The aim of this study was to analyze the indications for using bare metal stents (BMSs) in hospitalizations with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).
METHODS
The study cohorts were identified from the National Inpatient Sample database from 2010-2014 using appropriate, International Classification of Diseases, 9 Revision, Clinical Modification, diagnostic and procedural codes.
RESULTS
A total of 123,487 hospitalizations were identified for this study. Drug eluting stent (DES) use demonstrated lower in-hospital mortality (5.8% vs. 3.3%, P = < 0.01) and other in-hospital outcomes, thus resulting in lower hospitalization stay. Higher age, black race, greater comorbidity burden, inferior wall myocardial infarction, and the use of mechanical circulatory devices were all associated with BMS use.
CONCLUSION
DES was the preferred standard of care in the era of 2nd generation DES; however, BMSs were used in hospitalizations with high-risk procedures and multiple risk factors.
背景
本研究旨在分析在接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）住院患者中使用裸金属支架（BMS）的指征。
方法
使用适当的国际疾病分类第9版临床修订本诊断和程序编码，从2010年至2014年的国家住院样本数据库中确定研究队列。
结果
本研究共确定了123487例住院病例。药物洗脱支架（DES）的使用显示出较低的住院死亡率（5.8%对3.3%，P = <0.01）和其他住院结局，从而缩短了住院时间。高龄、黑人种族、更高的合并症负担、下壁心肌梗死以及使用机械循环装置均与BMS的使用相关。
结论
在第二代DES时代，DES是首选的标准治疗方法；然而，BMS用于高风险手术和存在多种风险因素的住院患者。
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