急性心肌梗死患者的抽吸血栓切除术——基于大型国家登记处（ORPKI）的5年分析
Aspiration Thrombectomy in Patients with Acute Myocardial Infarction-5-Year Analysis Based on a Large National Registry (ORPKI).
作者信息
Januszek Rafał, Siudak Zbigniew, Malinowski Krzysztof P, Wojdyła Roman, Mika Piotr, Wańha Wojciech, Kameczura Tomasz, Surdacki Andrzej, Wojakowski Wojciech, Legutko Jacek, Bartuś Stanisław
机构信息
2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland.
Department of Clinical Rehabilitation, University of Physical Education, 31-571 Kraków, Poland.
出版信息
J Clin Med. 2020 Nov 9;9(11):3610. doi: 10.3390/jcm9113610.
Blood flow restoration after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction (AMI) may not always be achieved and could be complicated by the no-reflow phenomenon (NRP). The aim of the current study was to assess the frequency of thrombus aspirations (TAs) and NRPs in patients with AMI and treated with pPCI based on the data collected during a 5-year period in the national ORPKI registry, as well as the frequency of periprocedural strokes and predictors of TA and NRP. This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), which covered the period between January 2014 and December 2018, and included 200,991 patients treated due to AMI out of 535,857 patients treated using PCI. Among them, 16,777 patients underwent TA. TA was mainly used in the STEMI subgroup of 14,207 patients (84.8%). The frequency of NRP among AMI patients in the thrombectomy group was 2.75% and in the non-thrombectomy group 0.82%. Predictors of TA and NRP were also assessed using multivariate analysis. The percentage of patients treated with pPCI and with PCI alone increased significantly in all of the three selected groups of patients from 88.7% to 94.3% in the AMI group ( < 0.001), from 82.3% to 90.3% in the STEMI subgroup ( < 0.001), and from 96.3% to 98.2% in the NSTEMI subgroup ( < 0.001) during the analysed period. NRP occurred more often in the thrombectomy group for the NSTEMI (0.58% vs. 3.07%, < 0.05) and STEMI (1.06% vs. 2.69%, < 0.05) subgroups. Periprocedural stroke occurred more often in the thrombectomy group in comparison to the non-thrombectomy group with AMI (0.03% vs. 0.01%, < 0.05) and the NSTEMI (0.16% vs. 0.02%, < 0.05). In conclusion, the frequency of TA has been experiencing a steady decline in recent years, regardless of AMI type, among patients treated with pPCI.
急性心肌梗死（AMI）患者在接受直接经皮冠状动脉介入治疗（pPCI）后，血流恢复情况并非总能如愿，且可能并发无复流现象（NRP）。本研究旨在基于国家ORPKI登记处5年期间收集的数据，评估接受pPCI治疗的AMI患者中血栓抽吸术（TA）和NRP的发生率，以及围手术期卒中的发生率、TA和NRP的预测因素。本回顾性分析是对波兰国家经皮冠状动脉介入治疗登记处（ORPKI）前瞻性收集的数据进行的，该数据涵盖2014年1月至2018年12月期间，在535,857例接受PCI治疗的患者中，有200,991例因AMI接受治疗。其中，16,777例患者接受了TA。TA主要用于14,207例STEMI亚组患者（84.8%）。血栓切除术组中AMI患者的NRP发生率为2.75%，非血栓切除术组为0.82%。还使用多变量分析评估了TA和NRP的预测因素。在分析期间，所选的三组患者中，仅接受pPCI和PCI治疗的患者百分比均显著增加，AMI组从88.7%增至94.3%（<0.001），STEMI亚组从82.3%增至90.3%（<0.001），NSTEMI亚组从96.3%增至98.2%（<0.001）。在NSTEMI（0.58%对3.07%，<0.05）和STEMI（1.06%对2.69%，<0.05）亚组中，血栓切除术组的NRP发生率更高。与AMI（0.03%对0.01%，<0.05）和NSTEMI（0.16%对0.02%，<0.05）的非血栓切除术组相比，血栓切除术组围手术期卒中的发生率更高。总之，近年来，无论AMI类型如何，接受pPCI治疗的患者中TA的发生率一直在稳步下降。
Zotero 插件