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2024年埃塞俄比亚亚的斯亚贝巴格桑德心脏与医学中心接受经皮冠状动脉介入治疗患者的临床特征与结局

Clinical characteristics and outcomes of patients undergoing percutaneous coronary intervention at Gesund Cardiac and Medical Center, Addis Ababa, Ethiopia, 2024.

作者信息

Eskias Kesete, Bekele Alemayehu, Adal Ousman, Hussien Heyria, Demisse Lemlem Beza

机构信息

Department of Emergency and Critical Care Nursing, College of Health Sciences, Addis Ababa University Addis Ababa, Ethiopia.

Department of Internal Medicine, College of Sciences, Addis Ababa University Addis Ababa, Ethiopia.

出版信息

Am J Cardiovasc Dis. 2025 Feb 15;15(1):29-38. doi: 10.62347/RIAQ1956. eCollection 2025.

Abstract

INTRODUCTION

Percutaneous coronary intervention (PCI) is a critical procedure for improving blood flow by alleviating arterial blockage. However, its availability in Ethiopia is limited because of insufficient resources, staff, and infrastructure.

OBJECTIVE

To evaluate the clinical characteristics and outcomes of patients who underwent percutaneous coronary intervention at Gesund Cardiac and Medical Center in Addis Ababa, Ethiopia, in 2024.

METHODS

This retrospective observational chart review included 224 patients who underwent percutaneous coronary intervention. Data were collected using a standardized checklist, imported into EPI information v7, and analyzed using SPSS v26. A binary logistic regression model was used to identify factors associated with percutaneous coronary intervention.

RESULTS

The study found that most participants (n = 186, 83%) were male, with a mean age of 57.82 ± 11.5 years. Diabetes mellitus was prevalent among participants (n = 135, 60.3%), followed by hypertension (n = 127, 56.7%). A notable portion (n = 31, 13.8%) had previously undergone percutaneous coronary intervention. Most patients presented with typical chest pain, with ST-Elevation Myocardial Infarction (STEMI) being the primary indication for percutaneous coronary intervention. Post-procedure complications includes significant bleeding (n = 6, 2.6%), myocardial infarction (n = 20, 8.9%), death (n = 2, 0.9%), transfer to another hospital (n = 12, 5.4%), and acute kidney injury (n = 16, 7.14%). The use of bare metal stents was significantly associated with transfer to other hospitals (AOR = 5; 95% CI = 1.69-10.29). Male gender (AOR = 0.09; 95% CI = 0.03-0.34) and a history of myocardial infarction (AOR = 10; 95% CI = 2.31-13.31) were linked to an increased risk of post-percutaneous coronary intervention death.

CONCLUSION AND RECOMMENDATIONS

Our findings suggest that coronary artery stenosis (CAS) is more prevalent in older individuals and men. Chronic illnesses often coexist with coronary artery stenosis, thereby complicating the prognosis. Interestingly, men exhibited a lower risk of unfavorable outcomes compared to women. Adherence to procedural guidelines and effective management techniques are essential for improving patient outcomes following percutaneous coronary intervention.

摘要

引言

经皮冠状动脉介入治疗(PCI)是一种通过缓解动脉阻塞来改善血流的关键手术。然而,由于资源、人员和基础设施不足,其在埃塞俄比亚的可及性有限。

目的

评估2024年在埃塞俄比亚亚的斯亚贝巴的格桑德心脏和医疗中心接受经皮冠状动脉介入治疗的患者的临床特征和结局。

方法

这项回顾性观察性病历审查纳入了224例接受经皮冠状动脉介入治疗的患者。使用标准化检查表收集数据,导入EPI信息v7,并使用SPSS v26进行分析。采用二元逻辑回归模型确定与经皮冠状动脉介入治疗相关的因素。

结果

研究发现,大多数参与者(n = 186,83%)为男性,平均年龄为57.82±11.5岁。糖尿病在参与者中很普遍(n = 135,60.3%),其次是高血压(n = 127,56.7%)。相当一部分患者(n = 31,13.8%)此前曾接受过经皮冠状动脉介入治疗。大多数患者表现为典型胸痛,ST段抬高型心肌梗死(STEMI)是经皮冠状动脉介入治疗的主要指征。术后并发症包括严重出血(n = 6,2.6%)、心肌梗死(n = 20,8.9%)、死亡(n = 2,0.9%)、转至另一家医院(n = 12,5.4%)和急性肾损伤(n = 16,7.14%)。使用裸金属支架与转至其他医院显著相关(调整后比值比[AOR]=5;95%置信区间[CI]=1.69 - 10.29)。男性(AOR = 0.09;95% CI = 0.03 - 0.34)和有心肌梗死病史(AOR = 10;95% CI = 2.31 - 13.31)与经皮冠状动脉介入治疗后死亡风险增加有关。

结论与建议

我们的研究结果表明,冠状动脉狭窄(CAS)在老年人和男性中更为普遍。慢性病常与冠状动脉狭窄并存,从而使预后复杂化。有趣的是,男性与女性相比不良结局风险较低。遵守手术指南和有效的管理技术对于改善经皮冠状动脉介入治疗后的患者结局至关重要。

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