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PHDP 再灌注治疗 ST 段抬高型心肌梗死患者的预后:1 年 MACCE 随访。

Prognosis in Patients with ST-Segment Elevation Myocardial Infarction Reperfused by PHDP: 1-Year MACEs Follow-Up.

机构信息

School of Medicine, Chengde Medical University, Chengde 067000, Hebei, China.

Department of Cardiology, Chengde Central Hospital/Second Clinical College of Chengde Medical University, Chengde 067000, Hebei, China.

出版信息

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241271394. doi: 10.1177/10760296241271394.

Abstract

This study explored 1-year follow-up of Parmaco-invasive strategy with half-dose recombinant human prourokinase (PHDP) in patients with acute ST-segment elevation myocardial infarction (STEMI). The follow-up endpoints were major adverse cardiovascular events (MACEs) occurring within 30 days and 1 year, as well as postoperative bleeding events. The study ultimately included 150 subjects, with 75 in the primary percutaneous coronary intervention (PPCI) group and 75 in the PHDP group. This study found that the PHDP group had a shorter FMC-reperfusion time (42.00 min vs 96.00 min, P < 0.001). During PCI, the PHDP group had a lower percutaneous transluminal coronary angioplasty (PTCA) (= 0.021), intropin (= 0.002) and tirofiban (< 0.001) use. And the incidence of intraoperative arrhythmia, malignant arrhythmia, and slow flow/no-reflow was lower in the PHDP group (< 0.001). At the 30-day follow-up, there was a significantly higher proportion of patients in the PPCI group who were readmitted due to unstable angina (= 0.037). After 1 year of follow-up, there was no statistically significant difference in MACEs between the two groups (= 0.500). The incidence of postoperative major bleeding, intracranial bleeding, and minor bleeding did not differ between the PHDP and PPCI groups (> 0.05). The PHDP facilitates early treatment of infarct-related vessels, shortens FMC-reperfusion time, and does not increase the risk of MACEs.

摘要

本研究探讨了半剂量重组人尿激酶原(PHDP)在急性 ST 段抬高型心肌梗死(STEMI)患者中的 1 年随访结果。随访终点为 30 天和 1 年内发生的主要不良心血管事件(MACE)以及术后出血事件。该研究最终纳入了 150 例患者,其中 75 例接受直接经皮冠状动脉介入治疗(PPCI),75 例接受 PHDP 治疗。研究发现,PHDP 组 FMC 再灌注时间更短(42.00min 比 96.00min,P<0.001)。在 PCI 过程中,PHDP 组经皮冠状动脉成形术(PTCA)(=0.021)、肾上腺素(=0.002)和替罗非班(<0.001)使用率较低。PHDP 组术中心律失常、恶性心律失常和慢血流/无复流的发生率较低(<0.001)。在 30 天随访时,PPCI 组因不稳定型心绞痛再入院的患者比例显著更高(=0.037)。在 1 年随访时,两组间 MACE 的发生率无统计学差异(=0.500)。PHDP 组和 PPCI 组术后大出血、颅内出血和轻度出血的发生率无差异(>0.05)。PHDP 有利于早期治疗梗死相关血管,缩短 FMC 再灌注时间,且不增加 MACE 风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f73/11325463/96f05145aae2/10.1177_10760296241271394-fig1.jpg

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