择期经皮冠状动脉介入术后当日出院的安全性和预测因素

Fabio Conejo, Henrique Barbosa Ribeiro, André Gasparini Spadaro, Roger Renault Godinho, Sandro M. Faig, Camila Gabrilaitis, Mariana Y. Okada, Alexandre Spósito, Carlos Vinícius Espirito-Santo, Marcelo Jamus Rodrigues, J. Carlos Teixeira Garcia, Pedro Gabriel Melo de Barros e Silva, Valter Furlan, Expedito E. Ribeiro
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引用次数: 1

摘要

背景:虽然择期无并发症经皮冠状动脉介入治疗(PCI)后当日出院(SDD)在世界范围内已被广泛采用,但在我国的相关研究仍甚少。我们的目的是评估选择性PCI术后SDD的初步经验,包括其安全性和成功的预测因素。方法选取某专科门诊就诊的161例连续单中心SDD患者。为了确定与SDD相关的因素,调整了单逻辑回归模型和多逻辑回归模型。结果114例患者(70.8%)成功行ssdd,其余47例患者住院,其中45例次日上午出院,2 d后出院。在30天或中位随访12个月时,没有SDD患者出现主要的不良心脏事件或主要血管并发症。住院组中仅1例发生侧支闭塞性急性心肌梗死,2例发生>5厘米血肿与通路部位有关。SDD预测因子为径向接入路径(OR = 5.92;95%可信区间1.73 - -20.21;p = 0.005),存在A/B1型病变(OR = 14.09;95%可信区间1.70 - -116.49%;p = 0.01)、对比体积(OR = 0.76;95%可信区间0.65 - -0.88;p & lt;0.001)。结论ssdd是安全的,在大多数选择择期PCI的患者中都能成功进行,其预测因素是桡动脉通路、冠状动脉病变复杂性较低和造影剂浓度较低。
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Safety and predictors of same day discharge after elective percutaneous coronary intervention

Background

Although same-day discharge (SDD) after elective uncomplicated percutaneous coronary intervention (PCI) be adopted worldwide, it remains poorly studied in our country. We aim to evaluate our initial experience with SDD after elective PCI, regarding its safety and predictors of success.

Methods

A hundred and sixty-one single-center consecutive patients, selected in a specialized outpatient clinic, were included for SDD. To identify the factors associated with SDD, single and multiple logistic regression models were adjusted.

Results

SDD was successfully performed in 114 patients (70.8%) and the remaining 47 patients remained hospitalized (45 with discharge in the following morning and 2 patients after 2 days). No patient with SDD presented major adverse cardiac events or major vascular complications at 30 days or at a median follow-up of 12 months. In the inpatient group, there was only one case of acute myocardial infarction due to a lateral branch occlusion and two patients with > 5 cm hematoma related to the access site. The SDD predictors were radial access route (OR = 5.92; 95%CI 1.73-20.21; p = 0.005), presence of type A/B1 lesions (OR = 14.09; 95%CI 1.70-116.49%; p = 0.01) and contrast volume (OR = 0.76; 95%CI 0.65-0.88; p < 0.001).

Conclusions

SDD was safe and could be successfully performed in most patients selected for elective PCI, and its predictors were the radial access, less complex coronary lesions and a and lower contrast volume.

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