压力控制间歇性冠状静脉窦闭塞（PiCSO）对前壁ST段抬高型心肌梗死梗死面积的影响：急性冠状动脉综合征（ACS）研究中的PiCSO
Effect of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size in anterior STEMI: PiCSO in ACS study.
作者信息
Egred Mohaned, Bagnall Alan, Spyridopoulos Ioakim, Purcell Ian F, Das Rajiv, Palmer Nick, Grech Ever D, Jain Ajay, Stone Gregg W, Nijveldt Robin, McAndrew Thomas, Zaman Azfar
机构信息
Freeman Hospital, Newcastle upon Tyne, UK.
Liverpool Heart and Chest Hospital, Liverpool, UK.
出版信息
Int J Cardiol Heart Vasc. 2020 May 15;28:100526. doi: 10.1016/j.ijcha.2020.100526. eCollection 2020 Jun.
BACKGROUND
The aim of this clinical research was to investigate the effects of Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) on infarct size at 5 days after primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI).
METHODS AND RESULTS
This comparative study was carried out in four UK hospitals. Forty-five patients with anterior STEMI presenting within 12 h of symptom onset received pPCI plus PiCSO (initiated after reperfusion; n = 45) and were compared with a propensity score-matched control cohort from INFUSE-AMI (n = 80). Infarct size (% of LV mass, median [interquartile range]) measured by cardiac magnetic resonance (CMR) at day 5 was significantly lower in the PiCSO group (14.3% [95% CI 9.2-19.4%] vs. 21.2% [95% CI 18.0-24.4%]; p = 0.023). There were no major adverse cardiac events (MACE) related to the PiCSO intervention.
CONCLUSIONS
PiCSO, as an adjunct to pPCI, was associated with a lower infarct size at 5 days after anterior STEMI in a propensity score-matched population.
背景
本临床研究旨在探讨压力控制间歇性冠状静脉窦闭塞（PiCSO）对ST段抬高型心肌梗死（STEMI）患者在直接经皮冠状动脉介入治疗（pPCI）后5天梗死面积的影响。
方法与结果
这项比较研究在英国的四家医院进行。45例症状发作12小时内就诊的前壁STEMI患者接受了pPCI加PiCSO（再灌注后开始；n = 45），并与来自INFUSE-AMI研究中倾向评分匹配的对照组（n = 80）进行比较。PiCSO组在第5天通过心脏磁共振（CMR）测量的梗死面积（左心室质量的百分比，中位数[四分位间距]）显著更低（14.3% [95% CI 9.2 - 19.4%] 对比 21.2% [95% CI 18.0 - 24.4%]；p = 0.023）。没有与PiCSO干预相关的主要不良心脏事件（MACE）。
结论
在倾向评分匹配的人群中，PiCSO作为pPCI的辅助治疗，与前壁STEMI后5天较低的梗死面积相关。
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