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越南接受经皮冠状动脉介入治疗患者的临床特征和院内结局的新见解。

Novel insights into clinical characteristics and in-hospital outcomes of patients undergoing percutaneous coronary intervention in Vietnam.

作者信息

Vu Hoa T T, Pham Hung M, Nguyen Hoai T T, Nguyen Quang N, Do Loi D, Pham Ngoc M, Norman Richard, Huxley Rachel R, Lee Crystal M Y, Reid Christopher M

机构信息

School of Public Health, Curtin University, Perth, Australia.

Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam.

出版信息

Int J Cardiol Heart Vasc. 2020 Sep 4;31:100626. doi: 10.1016/j.ijcha.2020.100626. eCollection 2020 Dec.

Abstract

BACKGROUND

Little is known about percutaneous coronary intervention (PCI) practices and outcomes in low-and middle-income nations, despite its rapid uptake across Asia. For the first time, we report on clinical characteristics and in-hospital outcomes for patients undergoing PCI at a leading cardiac centre in Vietnam.

METHODS

Information on characteristics, treatments, and outcomes of patients undergoing PCI was collected into the first PCI registry through direct interviews using a standardised form, medical record abstraction, and reading PCI imaging data on secured disks. Subgroup analysis was also conducted to explore gender differences.

RESULTS

Between September 2017 and May 2018, 1022 patients undergoing PCI were recruited from a total of 1041 procedures. The mean age was 68.3 years and two thirds were male. While 54.4% of patients presented with acute coronary syndromes, the rate of ST-elevation myocardial infarction was 14.5%. The majority of lesions were classified as type B2 and C and the radial artery was the most common access location for PCI (79.2%). The use of drug-eluting stents was universal and the angiographic success rate was 99.4%. Cardiac complications following PCI were rare with the exception of major bleeding (2.0%). Female patients were older with relatively more comorbidities and a higher incidence of major bleeding than males (p < 0.05).

CONCLUSIONS

Findings of this study provide an opportunity to benchmark current PCI practices in Vietnam, identify possible care gaps and potentially inform the adoption of treatment guidelines as well as use of prevention strategies.

摘要

背景

尽管经皮冠状动脉介入治疗(PCI)在亚洲迅速普及,但对于低收入和中等收入国家的PCI实践及结果却知之甚少。我们首次报告了越南一家领先心脏中心接受PCI治疗患者的临床特征和院内结局。

方法

通过使用标准化表格进行直接访谈、病历摘要以及读取安全磁盘上的PCI影像数据,将接受PCI治疗患者的特征、治疗及结局信息收集到首个PCI登记册中。还进行了亚组分析以探讨性别差异。

结果

2017年9月至2018年5月期间,从总共1041例手术中招募了1022例接受PCI治疗的患者。平均年龄为68.3岁,三分之二为男性。虽然54.4%的患者表现为急性冠状动脉综合征,但ST段抬高型心肌梗死的发生率为14.5%。大多数病变被归类为B2型和C型,桡动脉是PCI最常见的穿刺部位(79.2%)。药物洗脱支架的使用很普遍,血管造影成功率为99.4%。除大出血(2.0%)外,PCI术后心脏并发症很少见。女性患者年龄较大,合并症相对较多,大出血发生率高于男性(p<0.05)。

结论

本研究结果为衡量越南当前的PCI实践、识别可能的护理差距以及可能为采用治疗指南和预防策略提供依据提供了契机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f17/7481132/d17866410c7d/gr1.jpg

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