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首页> 外文期刊>The American Journal of Cardiology >Admissions Rate and Timing of Revascularization in the United States in Patients With Non-ST-Elevation Myocardial Infarction
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Admissions Rate and Timing of Revascularization in the United States in Patients With Non-ST-Elevation Myocardial Infarction

机译：非ST-EXTIVATION心肌梗死患者血运重建的入学率和时序

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Clinical trials have shown improved outcomes with an early invasive approach for non-ST-elevation myocardial infarction (NSTEMI). However, real-world data on clinical characteristics and outcomes based on time to revascularization are lacking. We aimed to analyze NSTEMI rates, revascularization timing, and mortality using the 2016 Nationwide Readmissions Database. We identify patients who underwent diagnostic angiography and subsequently received either percutaneous coronary intervention (PCI) or coronary artery bypass grafting ( CABG). Finally, revascularization timing and mortality rates (in-hospital and 30-day) were extracted. Our analysis included 748,463 weighted NSTEMI hospitalizations in 2016. Of these hospitalizations, 50.3% (376,695) involved diagnostic angiography, with 34.1% (255,199) revascularized. Of revascularized patients, 77.6% (197,945) underwent PCI and 22.4% (57,254) underwent CABG. Patients with more comorbidities tended to have more delayed revascularization. PCI was most commonly performed on the day of admission (32.9%; 65,155). This differs from CABG, which was most commonly performed on day 3 after admission (13.7%; 7,823). The in-hospital mortality rate increased after day 1 for PCI patients and after day 4 for CABG patients, whereas 30-day in-hospital mortality for both populations increased as revascularization was delayed. Our study shows that patients undergoing early revascularization differ from those undergoing later revascularization. Mortality is generally high with delayed revascularization, as these are sicker patients. Randomized clinical trials are needed to evaluate whether very early revascularization (<90 minutes) is associated with improved long-term outcomes in high-risk patients. (c) 2020 Elsevier Inc. All rights reserved.
机译：临床试验表明，非ST段抬高型心肌梗死（NSTEMI）的早期介入治疗可改善预后。然而，缺乏基于血运重建时间的临床特征和结果的真实数据。我们旨在使用2016年全国再入院数据库分析NSTEMI的发病率、血运重建时间和死亡率。我们确定接受诊断性血管造影并随后接受经皮冠状动脉介入治疗（PCI）或冠状动脉旁路移植术（CABG）的患者。最后，提取血运重建时间和死亡率（住院和30天）。我们的分析包括2016年748463例加权NSTEMI住院病例。在这些住院患者中，50.3%（376695）涉及诊断性血管造影，34.1%（255199）进行了血管重建。在血管重建患者中，77.6%（197945）接受PCI，22.4%（57254）接受CABG。合并症较多的患者血运重建延迟较多。PCI最常在入院当天进行（32.9%；65155）。这与CABG不同，后者通常在入院后第3天进行（13.7%；7823）。PCI患者在第1天和CABG患者在第4天之后的住院死亡率增加，而这两种人群的30天住院死亡率随着血运重建的延迟而增加。我们的研究表明，接受早期血运重建的患者与接受后期血运重建的患者不同。延迟血运重建的死亡率通常很高，因为这些患者病情更严重。需要进行随机临床试验，以评估早期血运重建（<90分钟）是否与高危患者的长期预后改善相关。（c） 2020爱思唯尔公司版权所有。

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