Danilushkin Yu V, Matchin Yu G, Shamrina N S, Bubnov D S, Atanesyan R V, Mitroshkin M G, Basinkevich A B, Ageev F T
A.L. Myasnikov Research Institute of Clinical Cardiology of National Medical Research Center of Cardiology, Ministry of Health of Russian Federation, Moscow, Russia.
Ter Arkh. 2019 May 16;91(4):74-82. doi: 10.26442/00403660.2019.04.000209.
To study the safety and clinical efficacy of an outpatient coronary angiography in various groups of patients according to a 6-year experience of the laboratory of endovascular diagnostic and treatment methods in the outpatient setting of the NMRC of Cardiology.
2166 patients which underwent an outpatient coronary agiography from March 2009 to December 2014 were included. The success criteria was the successful completion of the procedure without the occurrence of major cardiovascular complications (death, transmural myocardial infarction; acute cerebrovascular accident, emergency cardiac surgery).
All 2166 patients included in the study were divided into 2 groups: Group 1 - 1316 patients who were discharged home several hours after the study; Group 2 - 850 patients directed from hospitals without catheterization laboratories with the same-day discharge back to the referring hospital. From a clinical point of view, in the second group there were more severe patients. However, the study was successfully completed in all patients in both groups. There were no major adverse cardiovascular complications during the procedure and within 24 hours. In the 1st group, unplanned hospitalization occurred in 2.1% of cases, the cause of which in 93% of cases was the detection during angiography of a critical lesion ≥70% of the left main coronary artery.
In our work, the incidence of complications was extremely low and not significantly different in both groups of patients. This is due to the fact that in patients with a more severe symptoms underwent a preliminary stabilization of their clinical condition. The introduction of outpatient technologies will optimize the invasive diagnostics and reduce the costs associated with hospitalization.
根据心脏病国家医学研究中心门诊血管内诊断与治疗方法实验室6年的经验,研究门诊冠状动脉造影在不同患者群体中的安全性和临床疗效。
纳入2009年3月至2014年12月期间接受门诊冠状动脉造影的2166例患者。成功标准为手术成功完成且未发生重大心血管并发症(死亡、透壁心肌梗死、急性脑血管意外、急诊心脏手术)。
纳入研究的2166例患者分为2组:第1组 - 1316例患者在检查后数小时出院回家;第2组 - 850例患者从没有导管室的医院转入,当日出院后返回转诊医院。从临床角度看,第2组患者病情更严重。然而,两组所有患者的研究均成功完成。手术过程中和术后24小时内均未发生重大不良心血管并发症。在第1组中,2.1%的病例发生了非计划住院,其中93%的病例原因是在血管造影时发现左主干冠状动脉临界病变≥70%。
在我们的研究中,并发症发生率极低,两组患者之间无显著差异。这是因为症状更严重的患者临床状况得到了初步稳定。门诊技术的引入将优化侵入性诊断并降低与住院相关的费用。