Ahmad Musallam, Khalid Elrabbat, Mohamed Tabl, Hager Allam
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引用次数: 0
摘要
:背景:伴有多支血管疾病的急性心肌梗死具有较高的心血管风险,而此类患者的血管再通策略仍存在争议。我们的研究旨在评估对 ST 段抬高型心肌梗死(STEMI)患者进行完全血运重建与仅对罪魁祸首血管进行血运重建的潜在益处。方法:本研究是一项单中心前瞻性研究,对象是 150 名到纳斯尔市医院急诊科(ED)和心脏监护室(CCU)就诊的急性 ST 段抬高型心肌梗死患者,根据血管再通策略,患者被分为两组:第一组:出院前接受完全血管再通的患者;第二组:只接受罪魁祸首血管再通的患者。结果I 组患者的 MACE 明显较低(P<0.05)。完全血运重建组的非 ST 段急性冠脉综合征(NSTE-ACS)发生率和缺血驱动的血运重建需求分别显著降低(P=0.028 和 P=0.008)。结论:对于患有多血管疾病的 STEMI 患者,完全血管再通术与单纯罪魁祸首血管再通术策略相比,可降低 MACE 并改善短期预后。
Complete Versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction
: Background: Acute myocardial infarction with multivessel disease represents a higher cardiovascular risk and revascularization strategy in such patients remains a subject of conflict. The aim of our study was to assess the potential benefit of complete revascularization as compared to culprit vessel only revascularization in ST-segment elevation myocardial infarction (STEMI) patients who has multivessel disease (MVD). Methods: The current study is a single center prospective study conducted on 150 Patients presented with acute ST-segment elevation myocardial infarction to emergency department (ED) and cardiac care unit (CCU) in Nasr City Hospital, and according to revascularization strategy, patients were divided into two groups; Group I: patients received complete revascularization before hospital discharge and Group II: patients receiving culprit-only revascularization. Results: There was significant lower MACE in group I (p<0.05). The occurrence of non-ST segment acute coronary syndrome (NSTE-ACS) as well as the need for ischemia-driven revascularization-were significantly lower in the complete revascularization group (p=0.028 & p=0.008), respectively. Conclusion: in STEMI patients with multivessel disease, complete revascularization-as compared to culprit-only revascularization strategy-reduced MACE and improved short-term outcome.