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急性ST段抬高型心肌梗死患者在直接经皮冠状动脉介入治疗前自发再灌注的相关因素。

Associated factors of spontaneous reperfusion in patients with acute ST-segment elevation myocardial infarction before primary percutaneous coronary intervention.

作者信息

He Weimin, Lin Yixuan, Yuan Fengxin, Zhang Tong

机构信息

Department of Cardiology, The Sixth Affiliated Hospital, South China University of Technology, Foshan, China.

出版信息

Afr Health Sci. 2025 Jun;25(2):85-93. doi: 10.4314/ahs.v25i2.12.

Abstract

BACKGROUND

This is a retrospective analysis of the relationship between preoperative factors and spontaneous reperfusion (SR) in infarct-related arteries (IRAs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

METHODOLOGY

834 patients who were classified into the SR group (TIMI flow grade 2-3) and non-spontaneous reperfusion (NSR) group (TIMI flow grade 0-1) based on coronary angiography. The baseline characteristics and preoperative factors of the two groups were analyzed.

RESULTS

Compared with the NSR group, the SR group had shorter time from symptom onset to first medical contact (P=0.002) and from symptom onset to antiplatelet loading (P=0.003), however, there was no statistically significant difference in the mode of admission and loading of antiplatelet drugs between the two groups. Multivariate logistic regression analysis indicated that diabetes history, smoking history, triglyceride level, time from symptom onset to first medical contact, time from symptom onset to antiplatelet loading, and time from antiplatelet loading to coronary angiography were all factors influencing SR were all factors influencing SR.

CONCLUSION

The occurrence of SR is related to early medical contact and timely use of antiplatelet drugs. Patients with diabetes history, smoking history, higher triglyceride level may benefit more.

摘要

背景

这是一项回顾性分析,旨在研究接受经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者术前因素与梗死相关动脉(IRA)自发再灌注(SR)之间的关系。

方法

834例患者根据冠状动脉造影结果分为SR组(TIMI血流分级2 - 3级)和非自发再灌注(NSR)组(TIMI血流分级0 - 1级)。分析两组的基线特征和术前因素。

结果

与NSR组相比,SR组从症状发作到首次医疗接触的时间(P = 0.002)以及从症状发作到抗血小板负荷的时间(P = 0.003)更短,然而,两组之间的入院方式和抗血小板药物负荷并无统计学显著差异。多因素逻辑回归分析表明,糖尿病史、吸烟史、甘油三酯水平、从症状发作到首次医疗接触的时间、从症状发作到抗血小板负荷的时间以及从抗血小板负荷到冠状动脉造影的时间均为影响SR的因素。

结论

SR的发生与早期医疗接触和及时使用抗血小板药物有关。有糖尿病史、吸烟史、甘油三酯水平较高的患者可能获益更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fca/12361933/d79c275bdfbb/AFHS2502-0085Fig1.jpg

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