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经冠状动脉血流储备分数和冠状动脉造影指导下选择性介入治疗亚急性 ST 段抬高型心肌梗死的临床效果。

Clinical effect of selective interventional therapy on sub-acute ST-segment elevation myocardial infarction under the guidance of fractional flow reserve and coronary arteriography.

机构信息

Department of Cardiology, Huai'an First People's Hospital, Nanjing Medical University, No. 6 West Beijing Road, Huaiyin District, Huai'an, 223300, China.

Department of Cardiology, Drum Tower Hospital, Nanjing Medical University, Nanjing, 210008, China.

出版信息

Eur J Med Res. 2018 May 24;23(1):27. doi: 10.1186/s40001-018-0319-8.

Abstract

OBJECTIVE

This study aims to compare the clinical effects of selective interventional therapy (PCI) under the guidance of fractional flow reserve (FFR) and coronary arteriography.

METHODS

Patients with sub-acute ST-segment elevation myocardial infarction (sub-acute STEMI), who were under selective PCI treatment between April 2012 and June 2014, were included into this study. These patients were divided into two groups, based on FFR measurements: FFR-PCI group and radiography-PCI group. Then, differences in clinical symptoms, coronary angiography, intervention, and endpoint events were compared between these two groups.

RESULTS

A total of 592 patients with sub-acute STEMI were included in this study (207 patients in the FFR-PCI group and 385 patients in the radiography-PCI group). No statistical differences were observed in baseline clinical data and coronary angiography results between these two groups. Mean stent number was greater in the radiography-PCI group (1.22 ± 0.32) than in the FFR-PCI group (1.10 ± 0.29), and the difference was statistically significant (P = 0.019). During the follow-up period, 78 adverse events occurred (21 adverse events in the FFR-PCI group and 57 adverse events in the radiography-PCI group); and no statistical significance was observed between these two groups (log-rank P = 0.112).

CONCLUSION

Selective PCI treatment in patients with sub-acute STEMI under FFR acquired similar effects, compared to PCI treatment under the guidance of radiography, which can reduce the mean stent number.

摘要

目的

本研究旨在比较血流储备分数(FFR)指导下选择性介入治疗(PCI)与冠状动脉造影的临床效果。

方法

本研究纳入 2012 年 4 月至 2014 年 6 月期间接受选择性 PCI 治疗的亚急性 ST 段抬高型心肌梗死(亚急性 STEMI)患者。根据 FFR 测量值将这些患者分为 FFR-PCI 组和造影-PCI 组。然后比较两组的临床症状、冠状动脉造影、介入和终点事件的差异。

结果

本研究共纳入 592 例亚急性 STEMI 患者(FFR-PCI 组 207 例,造影-PCI 组 385 例)。两组患者的基线临床数据和冠状动脉造影结果无统计学差异。造影-PCI 组的平均支架数量(1.22±0.32)大于 FFR-PCI 组(1.10±0.29),差异有统计学意义(P=0.019)。随访期间,78 例患者发生不良事件(FFR-PCI 组 21 例,造影-PCI 组 57 例);两组间无统计学差异(对数秩检验 P=0.112)。

结论

与造影指导下的 PCI 治疗相比,FFR 指导下的亚急性 STEMI 患者选择性 PCI 治疗效果相似,但可减少平均支架数量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b118/5968604/a9814d553f59/40001_2018_319_Fig1_HTML.jpg

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