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[急性ST段抬高型心肌梗死患者使用机械血栓抽吸术与仅使用IIb/IIIa糖蛋白抑制剂相比院内主要心脏事件的发生率]

[Incidence of intrahospitalary major cardiac events with the use of mechanic thromboaspiration versus only use of IIB/IIIA glucoprotein inhibitors on patients with acute ST elevation myocardial infarction].

作者信息

Lendo-López Arcenio A, Galván-García José E, Trujillo-García Anival, Aguilar-Aguilar Luis F, Garay-Hansen Jorge A, Ramírez-Lastra Omar, Zapana-Céspedes Óscar, Meléndez-Mendoza Bernardo, Fajardo-Losada Ramiro J, Sandoval-Hernández Salvador I, León-Bojorquez Alan A, González-Serrato Luis A, Zurroza-Luna Kevin A, Palacios-Rodríguez Juan M

机构信息

Departamento de Hemodinamia y Cardiología Intervencionista, Hospital de Cardiología, Unidad Médica de Alta Especialidad No. 34, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México.

出版信息

Arch Cardiol Mex. 2024 May 29;94(4):467-473. doi: 10.24875/ACM.23000228.

Abstract

OBJECTIVE

To identify the incidence of in-hospital major adverse cardiac events (MACE) with the use of mechanic thromboaspiration plus IIb/IIIa glycoprotein inhibitors versus only use of IIb/IIIa glycoprotein inhibitors on patients with acute ST elevation myocardial infarction.

METHOD

Retrospective, observational, cohort analytic study, on patients with acute ST elevation myocardial infarction that had angiography thrombus TIMI 5 grade, treated between October 2021 and December 2022.

RESULTS

A total of 237 patients were included. In 113 patients thromboaspiration were used, 124 patients didn't used. 81.6% were men. In-hospital MACE occurred on 31.9% of patients with thromboaspiration use vs. 30.6% on patients with no use (RR: 1.05; IC95%: 0.61-1.93; p = 0.840). Incidence of malignant arrhythmias were of 8% with thromboaspiration use vs. 1.6% on patients with no use (RR: 5.27; IC95%: 1.11-24.97; p = 0.020).

CONCLUSIONS

The use of thromboaspiration on concomitant treatment with IIb/IIIa glycoprotein inhibitors was similar with only IIb/IIIa glycoprotein inhibitors in reducing incidence of in-hospital MACE on patients with ST elevation acute myocardial infarction and high thrombus burden. The study has several limitations, so results should be taken with caution.

摘要

目的

确定在急性ST段抬高型心肌梗死患者中,使用机械血栓抽吸联合IIb/IIIa糖蛋白抑制剂与仅使用IIb/IIIa糖蛋白抑制剂相比,院内主要不良心脏事件(MACE)的发生率。

方法

对2021年10月至2022年12月期间接受血管造影血栓TIMI 5级治疗的急性ST段抬高型心肌梗死患者进行回顾性、观察性队列分析研究。

结果

共纳入237例患者。113例患者使用了血栓抽吸,124例患者未使用。81.6%为男性。使用血栓抽吸的患者中有31.9%发生院内MACE,未使用的患者中有30.6%发生(相对危险度:1.05;95%置信区间:0.61 - 1.93;p = 0.840)。使用血栓抽吸的患者恶性心律失常发生率为8%,未使用的患者为1.6%(相对危险度:5.27;95%置信区间:1.11 - 24.97;p = 0.020)。

结论

在ST段抬高急性心肌梗死且血栓负荷高的患者中,血栓抽吸联合IIb/IIIa糖蛋白抑制剂与仅使用IIb/IIIa糖蛋白抑制剂在降低院内MACE发生率方面相似。本研究有若干局限性,因此结果应谨慎对待。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a4/12148534/bb2a7202f572/10125AMEX244-ACM-94-467-g001.jpg

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