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中国患者择期经皮冠状动脉介入治疗相关的心肌损伤:一项回顾性研究。

Myocardial damage associated with elective percutaneous coronary intervention in Chinese patients: a retrospective study.

机构信息

Department of Cardiovascular Disease, Huashan Hospital, Fudan University, Shanghai, China.

*These authors (Shengjia Sun and Yang Ou) contributed equally to this work.

出版信息

J Int Med Res. 2020 Mar;48(3):300060520907783. doi: 10.1177/0300060520907783.

Abstract

OBJECTIVE

To determine the prevalence of percutaneous coronary intervention (PCI) related myocardial damage (injury or myocardial infarction), investigate several cardiac biomarkers, explore possible risk factors and assess survival in patients undergoing elective PCI.

METHODS

Patients >18 years of age who had undergone an elective PCI at Huashan hospital in Shanghai, China from October 2016 to June 2017 and had baseline and post-PCI results available for four cardiac biomarkers (cTnT, CK-MB mass, hs-CRP and NT-ProBNP) were eligible. Patients were separated into two groups according to whether or not they had PCI related myocardial damage.

RESULTS

Of the 143 patients who were eligible for the study, 75 (52%) were classified as ‘controls,’ and 68 (48%) had PCI related myocardial damage. Of the 68 patients, 64 (45%) had PCI related myocardial injury and 4 (3%) had PCI related myocardial infarction. Elderly Chinese patients, with high systolic blood pressure on admission and who required multiple coronary segments for PCI had a high risk of myocardial damage. Relative cTnT or relative CK-MB mass may be useful cardiac biomarkers for monitoring PCI related myocardial damage, especially at 24h post-PCI. There was no significant difference in survival rates between controls and those with myocardial complications.

CONCLUSIONS

PCI related myocardial damage is common but appears to have no impact on prognosis. Senior age, high systolic blood pressure and multiple coronary segments for PCI are risk factors.

摘要

目的

确定经皮冠状动脉介入治疗(PCI)相关心肌损伤(损伤或心肌梗死)的发生率,研究几种心脏生物标志物,探讨可能的危险因素,并评估接受择期 PCI 患者的生存率。

方法

2016 年 10 月至 2017 年 6 月在上海华山医院接受择期 PCI 的年龄>18 岁的患者,基线和 PCI 后有四种心脏生物标志物(cTnT、CK-MB 质量、hs-CRP 和 NT-ProBNP)的结果可用,符合条件。患者根据是否存在 PCI 相关心肌损伤分为两组。

结果

在 143 名符合研究条件的患者中,75 名(52%)被归类为“对照组”,68 名(48%)有 PCI 相关心肌损伤。在 68 名患者中,64 名(45%)有 PCI 相关心肌损伤,4 名(3%)有 PCI 相关心肌梗死。高龄、入院时收缩压高且需要多支冠状动脉段进行 PCI 的中国老年患者,心肌损伤风险较高。相对 cTnT 或相对 CK-MB 质量可能是监测 PCI 相关心肌损伤的有用心脏生物标志物,尤其是在 PCI 后 24 小时。对照组和心肌并发症患者的生存率无显著差异。

结论

PCI 相关心肌损伤很常见,但似乎对预后没有影响。高龄、收缩压高和多支冠状动脉段进行 PCI 是危险因素。

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