李东宝, 华琦, 刘志, 李虹伟, 陈晖. 分叉病变对急性心肌梗死急诊介入治疗效果的影响[J]. 心脏杂志, 2011, 23(4): 507. DOI: 61-1268/R.20110503.1636.022
    引用本文: 李东宝, 华琦, 刘志, 李虹伟, 陈晖. 分叉病变对急性心肌梗死急诊介入治疗效果的影响[J]. 心脏杂志, 2011, 23(4): 507. DOI: 61-1268/R.20110503.1636.022
    Impact of bifurcated lesions on prognosis of emergency percutaneous coronary intervention in patients with acute myocardial infarction[J]. Chinese Heart Journal, 2011, 23(4): 507. DOI: 61-1268/R.20110503.1636.022
    Citation: Impact of bifurcated lesions on prognosis of emergency percutaneous coronary intervention in patients with acute myocardial infarction[J]. Chinese Heart Journal, 2011, 23(4): 507. DOI: 61-1268/R.20110503.1636.022

    分叉病变对急性心肌梗死急诊介入治疗效果的影响

    Impact of bifurcated lesions on prognosis of emergency percutaneous coronary intervention in patients with acute myocardial infarction

    • 摘要: 目的:探讨分叉病变对ST段抬高型急性心肌梗死(STEMI)患者急诊冠脉介入治疗(PCI)效果的影响。方法: 318例连续入选的STEMI患者在发病12 h内行PCI,根据冠脉造影提示是否为分叉病变分为分叉组(n=92)和非分叉组(n=226)。结果: 分叉组PCI的成功率为86%,与非分叉组(84%)相比无显著差异。两组30 d主要不良事件也无统计学差异(分叉组与非分叉组:6% vs. 7%)。结论: STEMI患者急诊PCI治疗分叉病变的即刻和近期疗效与无分叉病变相近。

       

      Abstract: AIM:To investigate the impact of bifurcated lesions on the short-term prognosis after percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarction (AMI). METHODS: A total of 318 consecutive AMI patients treated with primary PCI within 12 h of symptom onset were divided into bifurcated group (n=92) and non-bifurcated group (n=226) based on the cineangiogram performed during PCI. RESULTS: Bifurcated lesions on angiography were found in 28.9% of the patients and predominantly involved the left anterior descending artery. In the bifurcated group, double guidewire protection, one stent plus “kissing balloon” techniques and provisional T-stenting were used, respectively, in 46%, 36% and 10% of the patients. The procedural success rate was 86% for the main artery bifurcation compared with 84% for the nonbifurcated lesion (P=0.89). No significant difference was observed in the 30-day major adverse event rates between groups (6% of bifurcated group vs. 7% of non-bifurcated group, P=0.86). CONCLUSION: In patients with ST segment elevation, AMI, immediate and short-term prognoses of PCI are similar for bifurcated and nonbifurcated lesion.

       

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