不同时间窗干预非ST段抬高型急性冠状动脉综合征疗效观察

被引:4
作者
张峻
乔树宾
朱俊
机构
[1] 中国医学科学院 北京协和医学院 阜外心血管病医院冠心病诊疗中心
[2] 中国医学科学院 北京协和医学院
关键词
冠状动脉疾病; 血管成形术,经腔,经皮冠状动脉;
D O I
暂无
中图分类号
R686 [筋腱、韧带、滑囊疾病及损伤];
学科分类号
摘要
目的比较非ST段抬高型急性冠状动脉综合征患者早期干预和延迟干预的有效性和安全性。方法本试验为多中心随机研究,将入选的非ST段抬高型急性冠状动脉综合征患者分配至早期组(24 h内接受冠状动脉造影)和延迟组(36 h后接受冠状动脉造影),接受介入治疗或冠状动脉旁路移植术。主要终点是180 d随访时死亡、心肌梗死、卒中的复合终点,次要终点是180 d随访时死亡、心肌梗死、难治性缺血、卒中、再次血运重建。结果共有815例患者入选,主要终点事件发生率早期组为9.0%,延迟组为14.6%(P=0.01)。次要终点事件(180 d死亡、心肌梗死或难治性缺血复合终点)的发生率早期组为14.6%,延迟组为22.0%(P=0.01)。180 d心肌梗死发生率延迟组高于早期组(10.8%比5.2%,P=0.00)。另一个次要终点事件(180 d死亡、心肌梗死、难治性缺血、卒中或再次血运重建复合终点)的发生率早期组为26.7%,延迟组为30.4%(P=0.25)。结论早期干预可以减少非ST段抬高型急性冠状动脉综合征患者再发心肌梗死的发生率。
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