Myrda Krzysztof, Gąsior Mariusz, Dudek Dariusz, Nawrotek Bartłomiej, Niedziela Jacek, Wojakowski Wojciech, Gierlotka Marek, Grygier Marek, Stępińska Janina, Witkowski Adam, Lesiak Maciej, Legutko Jacek
Silesian Center for Heart Diseases, 3rd Department of Cardiology, 41-800 Zabrze, Poland.
3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
J Clin Med. 2021 Oct 29;10(21):5059. doi: 10.3390/jcm10215059.
We aimed to evaluate the effect of intravenous glycoprotein IIb/IIIa receptor inhibitors (GPIs) on in-hospital survival and mortality during and at the 1-year follow-up in patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) complicated by cardiogenic shock (CS), who were included in the Polish Registry of Acute Coronary Syndromes (PL-ACS).
From 2003 to 2019, 466,566 MI patients were included in the PL-ACS registry. A total of 10,193 patients with CS received PCI on admission. Among them, GPIs were used in 3934 patients.
The patients treated with GPIs were younger, had lower systolic blood pressure on admission, required inotropes and intra-aortic balloon pump (IABP) support more frequently, and showed a lower efficacy of coronary angioplasty. In both groups, the same rates of in-hospital adverse events were observed. A lower mortality rate was reported in the group treated with GPIs 12 months after admission (54.9% vs. 57.9%, = 0.002). Therapy with GPI was an independent factor reducing the risk of mortality in the 12-month follow-up.
The addition of GPIs to the standard pharmacotherapy combined with PCI in patients with MI and CS on admission reduced the risk of death in the 12-month follow-up period without increasing in-hospital adverse event rates.
我们旨在评估静脉注射糖蛋白IIb/IIIa受体抑制剂（GPIs）对因心肌梗死（MI）并发心源性休克（CS）而接受经皮冠状动脉介入治疗（PCI）的患者在住院期间及1年随访时的生存和死亡影响，这些患者被纳入波兰急性冠状动脉综合征注册研究（PL-ACS）。
2003年至2019年，466,566例MI患者被纳入PL-ACS注册研究。共有10,193例CS患者入院时接受了PCI。其中，3934例患者使用了GPIs。
使用GPIs治疗的患者更年轻，入院时收缩压更低，更频繁地需要使用血管活性药物和主动脉内球囊反搏（IABP）支持，且冠状动脉血管成形术的疗效较低。两组住院期间不良事件发生率相同。入院12个月后，使用GPIs治疗的组报告的死亡率较低（54.9%对57.9%，P = 0.002）。在12个月的随访中，GPI治疗是降低死亡风险的独立因素。
对于入院时患有MI和CS的患者，在标准药物治疗联合PCI的基础上加用GPIs可降低12个月随访期内的死亡风险，且不增加住院期间不良事件发生率。
