青年人经皮冠状动脉介入治疗的结果

Satya Lakshmi Vanaparty, Lalita Nemani, Jahangir Sheik
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摘要

背景:青年人冠状动脉疾病的发病率不断上升。了解年轻人经皮冠状动脉介入治疗(PCI)的结果是必要的。本研究旨在评估年轻人(<40岁)PCI的手术结果、住院结果和1年临床结果。方法:这是一项在尼扎姆医学科学研究所心内科进行的前瞻性观察性研究。本研究纳入所有年龄≤40岁且于2019年1月1日至2019年12月31日在我院行PCI的受试者。结果:共纳入207例患者,平均年龄36.01±3.72岁,男性占72.46%。急性冠脉综合征发生率为79.2%,ST段抬高型心肌梗死(STEMI)最为常见。STEMI患者出现的中位时间间隔为12-48小时(73%)。1年内主要心脏不良事件(MACE)发生率为3.8%。发病时严重的左心室功能障碍是急性(P = 0.04)和1年死亡率(P = 0.0058)的独立因素。它还与心绞痛和慢性心力衰竭(CHF)有关。血流缓慢与死亡率(P = 0.0254)和不良的1年预后显著相关。它与持续的左室功能障碍和复发的CHF显著相关。结论:青壮年PCI术后成功率高。1年预后非常好,死亡率和MACE事件较低。严重左室功能障碍和血流缓慢是1年预后不良的独立预测因素。
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Outcomes of Percutaneous Coronary Intervention in the Young
Background: The incidence of coronary artery disease in the young is constantly rising. Understanding the outcomes of percutaneous coronary intervention (PCI) in young adults is necessary. This study aims to assess the procedural outcomes, inhospital and 1 year clinical outcomes of PCI in the young (<40-year-old). Methods: This is a prospective, observational study carried out in the Department of Cardiology at Nizam's Institute of Medical Sciences. The study included all subjects ≤40 years of age and has undergone PCI from January 1, 2019 to December 31, 2019 in our institute. Results: The study included 207 patients with a mean age of 36.01 ± 3.72 years and 72.46% males. Acute coronary syndrome was seen in 79.2% patients with ST elevation myocardial infarction (STEMI) being the most common. The median time interval of presentation in STEMI was 12–48 h (73%). Major adverse cardiac events (MACE) over 1-year were seen in 3.8% patients. Severe left ventricular (LV) dysfunction at presentation was an independent factor for acute (P = 0.04) and 1-year mortality (P = 0.0058). It was also associated with angina and chronic heart failure (CHF). Slow flow was significantly associated with mortality (P = 0.0254) and adverse 1 year outcomes. It was significantly associated with persistent LV dysfunction and recurrent CHF. Conclusion: Success rate after PCI is high in the young. 1 year outcome is very good with low mortality and MACE events. Severe LV dysfunction and slow flow are independent predictors of poor prognosis at 1 year.
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