摘要
目的了解非ST段抬高急性冠状动脉综合征(ACS)患者在住院当日行经皮冠状动脉介入治疗(PCI)的安全性和住院临床结果。方法 SUNDAY(Strategies for UA／NSTEMI and Delay of AngioplastY)为单中心回顾性注册研究,入选2000年1月至2002年12月3年间首次因非ST段抬高急性冠脉综合征在本院住院的1013例患者,记录患者的临床特点、治疗经过以及住院心血管事件等情况。本研究选择SUNDAY注册中冠状动脉造影后接受PCI的患者,比较当日(≤24 h)PCI和入院24 h以后行PCI的安全性和住院临床结果。结果在SUNDAY注册的1013例患者中,共有438例患者入院后接受冠状动脉造影和PCI。35例和 403例分别于入院≤24 h(当日PCI组)和24 h以后(非当日PCI组)行PCI。两组基础临床特征基本相似。当日PCI组和非当日PCI组分别在入院后(22±7)h和(142±152)h行冠状动脉造影(P<0．01),两组分别于入院后(1．0±0．0)d和(7．5±7．3)d行PCI(P<0．01),PCI成功率分别为97．1％与97．0％(P> 0．05)。完全血管重建率分别为62．9％与53．6％(P>0．05)。两组住院期间均无死亡,住院新发心肌梗死发生率分别为2．9％与1．2％(P:0．395),再次血管重建率分别为0与0．2％(P>0．05),主要不良心脏事件 (包括死亡、新发心肌梗死、再次血管重建)发生率分别为2．9％与1．5％(P>0．05)。当日PCI组的住院时间分别为(7．7±3．0)d与(15．2±9．8)d(P<0．01),住院费用分别为(6．1±2．3)万元与(6．4±3．1)万元(P=0．582)。结论非ST段抬高急性冠脉综合征患者在住院当日接受冠状动脉造影并行PCI安全可行, 其成功率较高,临床事件发生率较低,能显著缩短住院日,并有降低住院费用的趋势。
Objective To investigate the safety and in-hospital clinical outcome of pereutaneous coronary intervention （PCI） within 24 hours after admission, called same-day PCI, in patients with non-ST-elevation acute coronary syndrome. Methods SUNDAY （Strategies for UA/NSTEMI and Delay of AngioplastY） single-center registry, was used. Clinical features, treatment and in-hospital outcome of 1013 hospitalized patients with non-ST-elevation acute coronary syndrome from January 2000 to December 2002 were recorded. Patients who received PCI after coronary angiography （CAG） were selected to compare the safety and clinical outcome of same-day PCI （ ≤24 hours） and not-same-day （ 〉 24 hours） PCI. Results Among 1013 patients enrolled in the SUNDAY registry, 438 （male 74.8%, unstable angina 94.1% ） received PCI after CAG, 35 patients received PCI within 24 hours [ （ 1.0 ± 0.0） day, group Ⅰ and 403 after 24 hours [ （7.5 ± 7.3） days, group Ⅱ of hospitalization （P 〈 0.0001）. Baseline angiographie and clinical characteristics of the two groups were comparable. Procedural success rates and complete revascularization rates were also similar. During hospitalization, no patients died after PCI with new-onset rates of myocardial infarction （2.9% vs 1.2%, P= 0.395）, rovascularization （0 vs 0.2%, P = 1.000） and major adverse cardiac events （death, new-onset myocardial infarction or revascularization） （2.9% vs 1.5%, P = 0.444） in group Ⅰ and group Ⅱ . Patients in group Ⅰ PCI had a shorter hospital stay and less hospital cost than in group Ⅱ [ （7.7 ± 3.0） vs （15.2 ± 9.8） days, P 〈 0.0001] [ （61000±23000） vs （64000±31000） RMB, P=0.582]. Conclusion Same-day PCI for patients with non-ST-elevation acute coronary syndrome was safe and feasible, with high procedural success rate, low adverse event rate, shorter hospital stay and less hospital cost.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第5期426-428,共3页
Chinese Journal of Emergency Medicine
基金
国家重点基础研究发展规划(973计划)资助项目(2003CB517103)
关键词
冠状动脉疾病
冠状动脉造影
主要不良心脏事件
早期侵入策略
Coronary artery disease
Coronary angiography
Major adverse cardiac events
Early invasive strategies
