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三级心脏护理中心经桡动脉途径进行直接经皮冠状动脉介入治疗的结果

Outcomes of Primary Percutaneous Coronary Intervention through a Transradial Approach in a Tertiary Care Cardiac Center.

作者信息

Soomro Najia A, Khan Muhammad N, Naseeb Khalid, Batra Mahesh K, Majeed Haris, Bhatti Usman, Ashraf Tariq, Karim Musa

机构信息

Cardiology, Liaquat National Hospital, Karachi, PAK.

Interventional Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, PAK.

出版信息

Cureus. 2019 Dec 27;11(12):e6484. doi: 10.7759/cureus.6484.

Abstract

Background Transradial approach for percutaneous coronary intervention (PCI) is gaining popularity due to lesser bleeding and other access site related complications. This study aims to determine the in-hospital outcomes of primary PCI through a transradial approach in a tertiary care cardiac center. Methods Consecutive patients with ST-segment elevation myocardial infarction presenting within 12 hours with symptoms without a previous history of thrombolytic therapy, coronary angioplasty, or cardiac surgery were included in the study. All patients underwent a diagnostic angiogram followed by primary PCI of the infarct-related artery through a radial route and were kept under observation during the hospital stay for forearm hematoma or mortality. Results A total of 180 patients were included in this study, with a mean age of 52.04±7.31 years. Majority (87.2%) of the patients were male, and diabetes (72.8%) was the most commonly observed co-morbid condition followed by hypertension (67.2%). Hospital mortality rate was 3.9% (7 patients), and post-procedure forearm hematoma was noted in 5.6% (10 patients). An increased mortality rate was found to be associated with age above 50 years (7.1% vs. 0.0%; p=0.012) and non-hypertension (8.5% vs. 1.7%; p=0.026). An increased incidence of forearm hematoma was found to be associated with age above 50 years (10.2% vs. 0.0%; p=0.002), diabetic mellitus (7.6% vs. 0.0%; p=0.047), hyperlipidemia (11% vs. 0.0%; p=0.001), and non-smoking (10.2% vs. 0.0%; p=0.003). Conclusion Our study showed that primary PCI through a transradial approach is a safe option with excellent success rates in terms of both mortality rates and morbidity such as forearm hematoma.

摘要

背景 经桡动脉途径进行经皮冠状动脉介入治疗(PCI)因出血较少及其他与穿刺部位相关的并发症而越来越受欢迎。本研究旨在确定在一家三级心脏护理中心通过经桡动脉途径进行直接PCI的院内结局。方法 连续纳入发病12小时内出现症状、既往无溶栓治疗、冠状动脉成形术或心脏手术史的ST段抬高型心肌梗死患者。所有患者均接受诊断性血管造影,随后通过桡动脉途径对梗死相关动脉进行直接PCI,并在住院期间观察前臂血肿或死亡率。结果 本研究共纳入180例患者,平均年龄为52.04±7.31岁。大多数患者(87.2%)为男性,最常见的合并症是糖尿病(72.8%),其次是高血压(67.2%)。医院死亡率为3.9%(7例患者),术后前臂血肿发生率为5.6%(10例患者)。发现死亡率增加与年龄超过50岁(7.1%对0.0%;p=0.012)和非高血压(8.5%对1.7%;p=0.026)相关。发现前臂血肿发生率增加与年龄超过50岁(10.2%对0.0%;p=0.002)、糖尿病(7.6%对

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