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首页> 外文期刊>Critical care medicine >Percutaneous coronary intervention for nonculprit vessels in cardiogenic shock complicating ST-segment elevation acute myocardial infarction
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Percutaneous coronary intervention for nonculprit vessels in cardiogenic shock complicating ST-segment elevation acute myocardial infarction

机译：经皮冠状动脉介入治疗非心源性血管性心源性休克并发ST段抬高急性心肌梗死

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OBJECTIVES:: We investigated the clinical impact of multivessel percutaneous coronary intervention in ST-segment elevation myocardial infarction complicated by cardiogenic shock with multivessel disease. DESIGN:: A prospective, multicenter, observational study. SETTING:: Cardiac ICU of a university hospital. PATIENTS:: Between November 2005 and September 2010, 338 patients were selected. Inclusion criteria were as follows: 1) ST-segment elevation myocardial infarction with cardiogenic shock and 2) multivessel disease with successful primary percutaneous coronary intervention for the infarct-related artery. Patients were divided into multivessel percutaneous coronary intervention and culprit-only percutaneous coronary intervention. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Primary outcome was all-cause mortality. Median follow-up duration was 224 days (interquartile range, 46-383 d). Multivessel percutaneous coronary intervention was performed during the primary percutaneous coronary intervention in 60 patients (17.8%). In-hospital mortality was similar in both groups (multivessel percutaneous coronary intervention vs culprit-only percutaneous coronary intervention, 31.7% vs 24.5%; p = 0.247). All-cause mortality during follow-up was not significantly different between the two groups after adjusting for patient, angiographic, and procedural characteristics as well as propensity scores for receiving multivessel percutaneous coronary intervention (35.0% vs 30.6%; adjusted hazard ratio, 1.06; 95% CI, 0.61-1.86; p = 0.831). There were no significant differences between the groups in rates of major adverse cardiac events (41.7% vs 37.1%; adjusted hazard ratio, 1.03; 95% CI, 0.62-1.71; p = 0.908) and any revascularization (6.7% vs 4.7%; adjusted hazard ratio, 1.88; 95% CI, 0.51-6.89; p = 0.344). CONCLUSIONS:: Multivessel percutaneous coronary intervention could not reduce the prevalence of mortality in patients with cardiogenic shock complicating ST-segment elevation myocardial infarction and multivessel disease during primary percutaneous coronary intervention.
机译：目的：我们研究了多支血管经皮冠状动脉介入治疗对ST段抬高型心肌梗死并发心源性休克伴多支血管疾病的临床影响。设计：：一项前瞻性，多中心，观察性研究。地点：大学医院的心脏加护病房。患者：在2005年11月至2010年9月之间，选择了338名患者。纳入标准如下：1）ST段抬高型心肌梗死合并心源性休克; 2）多支血管病变，对梗死相关动脉进行了一次成功的经皮冠状动脉介入治疗。将患者分为多支血管经皮冠状动脉介入治疗和仅罪犯的经皮冠状动脉介入治疗。干预措施：：无。测量和主要结果：主要结果是全因死亡率。中位随访时间为224天（四分位间距为46-383 d）。在60例初次经皮冠状动脉介入治疗中进行了多支血管经皮冠状动脉介入治疗（17.8％）。两组的院内死亡率均相似（多支血管经皮冠状动脉介入治疗与仅罪犯的经皮冠状动脉介入治疗，分别为31.7％和24.5％; p = 0.247）。在对患者，血管造影和手术特征以及接受多支血管经皮冠状动脉介入治疗的倾向评分进行调整后，两组的随访期间全因死亡率无显着差异（35.0％比30.6％;调整后的危险比为1.06; 95％CI，0.61-1.86; p = 0.831）。两组之间在主要不良心脏事件发生率（41.7％vs 37.1％;调整后的危险比，1.03; 95％CI，0.62-1.71; p = 0.908）和任何血运重建方面（6.7％vs. 4.7％;两组之间无显着差异）。调整后的危险比为1.88; 95％CI为0.51-6.89; p = 0.344）。结论：在原发性经皮冠状动脉介入治疗期间，多支血管经皮冠状动脉介入治疗不能降低心源性休克并发ST段抬高型心肌梗死和多支血管疾病的心源性休克患者的死亡率。

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