Impella 循环支持治疗高危经皮冠状动脉介入治疗的短期结果：系统评价和荟萃分析。
Short term outcomes of Impella circulatory support for high-risk percutaneous coronary intervention a systematic review and meta-analysis.
机构信息
Division of Cardiology, Department of Medical Science, University of Turin, Turin, Italy.
Division of Cardiology, Ospedale San Giovanni Bosco, Turin, Italy.
出版信息
Catheter Cardiovasc Interv. 2022 Jan 1;99(1):27-36. doi: 10.1002/ccd.29757. Epub 2021 May 24.
OBJECTIVE
Aim of this study is to evaluate short term safety and efficacy of Impella in high risk percutaneous coronary intervention (HR-PCI) population.
BACKGROUND
While several studies demonstrated the clinical significance of Impella in HR-PCI, few data exist about its impact on short term outcome.
METHODS
All studies reporting short term outcomes of PCI with any Impella device were included. The primary endpoint was either in-hospital or 30-day mortality, while vascular complications, post-procedural stroke, post-procedural dialysis and bleeding complications were assessed as secondary outcomes.
RESULTS
Nine studies with 7448 patients were included. Median age was 69.5 years old (67-73), with a mean ejection fraction of 29.7% (20%-39%) and a Syntax score of 30.2 (25. 5-33, interquartile [IQR]). Impella 2.5 was the most commonly used axial flow pump used to support these PCIs (88.7%). In-hospital death was observed in 5.09% of patients (95% confidence interval [CI] 3.69-6.49, I = 78%), while vascular complications in 2.53% of patients (1.07-4.00, I = 89%) and post-procedural stroke in 2.77% of patients (0.50-6.05, I = 98%). Major bleeding occurred in 5.98% of patients (3.66-8.31, I = 90%) and post-procedural dialysis in 4.44% of patients (1.50-7.37, I = 93% all CI 93%).
CONCLUSION
Use of Impella in high risk PCI appears to have an acceptable rate of complication, especially regarding vascular complications and major bleedings.
目的
本研究旨在评估 Impella 在高危经皮冠状动脉介入治疗（HR-PCI）人群中的短期安全性和疗效。
背景
虽然多项研究表明 Impella 在 HR-PCI 中的临床意义，但关于其对短期结局影响的数据较少。
方法
纳入所有报告使用任何 Impella 装置进行 PCI 的短期结局研究。主要终点为住院期间或 30 天死亡率，次要终点为血管并发症、术后卒中、术后透析和出血并发症。
结果
纳入 9 项研究共 7448 例患者。中位年龄为 69.5 岁（67-73 岁），平均射血分数为 29.7%（20%-39%），Syntax 评分 30.2（25.5-33，四分位距 [IQR]）。最常使用的轴向血流泵为 Impella 2.5 以支持这些 PCI（88.7%）。住院期间死亡发生率为 5.09%（95%置信区间 [CI] 3.69-6.49，I ² = 78%），血管并发症发生率为 2.53%（1.07-4.00，I ² = 89%），术后卒中发生率为 2.77%（0.50-6.05，I ² = 98%）。大出血发生率为 5.98%（3.66-8.31，I ² = 90%），术后透析发生率为 4.44%（1.50-7.37，I ² = 93%，所有 CI 均为 93%）。
结论
高危 PCI 中使用 Impella 的并发症发生率似乎可以接受，尤其是血管并发症和大出血。
Zotero 插件