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首页> 外文期刊>International heart journal >Timing of Staged Percutaneous Coronary Intervention for a Non-Culprit Lesion in Patients With Anterior Wall ST Segment Elevation Myocardial Infarction With Multiple Vessel Disease
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Timing of Staged Percutaneous Coronary Intervention for a Non-Culprit Lesion in Patients With Anterior Wall ST Segment Elevation Myocardial Infarction With Multiple Vessel Disease

机译：前壁ST段抬高型心肌梗死合并多支血管疾病患者的非罪状病变分期经皮冠状动脉介入治疗的时机

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The optimal timing of a staged percutaneous coronary intervention (PCI) for non-culprit lesions in patients with STsegment elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) remains controversial. We focused on patients with anterior wall STEMI with MVD and determined the clinical effects for timing of staged PCI. From November 2005 to December 2014, 258 patients were diagnosed with anterior wall STEMI with MVD in our hospital. Among them, 37 patients received staged PCI within 3 weeks, 50 patients received staged PCI during 3 weeks to one year, and 167 patients received only primary PCI for culprit lesions. Clinical outcomes such as admission for angina or heart failure, target vessel revascularization, myocardial infarction, stroke, cardiovascular mortality, and allcause mortality were compared among the 3 groups. Acute kidney injury (AKI) after PCI occurred in 18.9% of the 3-week group, 0% of the one-year group, and 7.6% of the control group ( P = 0.005). Of the one-year and 3-year clinical outcomes, the one-year group had better results, such as fewer major adverse cardiac cerebral events ( P = 0.028, P = 0.023), and lower recurrent MI ( P = 0.065; P = 0.018), cardiovascular mortality ( P = 0.043; P = 0.020), and all-cause mortality ( P = 0.047; P = 0.005). In patients with anterior wall STEMI with MVD, staged PCI for a non-culprit lesion over 3 weeks to one year had a better clinical outcome. Staged PCI for a non-culprit lesion within 3 weeks may be related to the occurrence of AKI, may lead to worse clinical outcomes, and did not decrease the occurrence of angina or post-MI heart failure.
机译：ST段抬高型心肌梗死（STEMI）多血管疾病（MVD）患者的非罪犯病变的分期经皮冠状动脉介入治疗（PCI）的最佳时机仍然存在争议。我们针对前壁STEMI合并MVD的患者，确定了分期PCI时机的临床效果。从2005年11月至2014年12月，我院诊断为258例MVD的前壁STEMI患者。其中37例在3周内接受了分期PCI，50例在3周至一年内接受了分期PCI，167例仅接受了原发性PCI作为罪魁祸首。比较了三组患者的临床结果，如心绞痛或心力衰竭的入院率，靶血管的血运重建，心肌梗塞，中风，心血管疾病的死亡率和全因死亡率。 3周组PCI发生急性肾损伤（AKI）的发生率为18.9％，一年组为0％，对照组为7.6％（P = 0.005）。在一年和三年的临床结果中，一年组的结果更好，例如重大的不良心脏脑事件（P = 0.028，P = 0.023）和较低的复发性MI（P = 0.065; P = 0.018），心血管疾病死亡率（P = 0.043; P = 0.020）和全因死亡率（P = 0.047; P = 0.005）。对于前壁STEMI伴MVD的患者，在3周至一年内分期行PCI治疗非罪犯病变具有更好的临床效果。在3周内对非罪犯病变进行分期PCI可能与AKI的发生有关，可能导致较差的临床结果，并且未减少心绞痛或MI后心力衰竭的发生。

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