冠状动脉内支架植入成功与否对严重心脏事件发生的影响

Risk factors related to major adverse cardiac events during intracoronary stenting

目的 探讨冠状动脉内支架植入成功与否对严重心脏事件发生的影响。方法 63 2例冠心病患者 75 6处病变以标准方法行经皮冠状动脉腔内成形术和支架术。手术成功的标准为残余狭窄≤ 3 0 %且心肌梗死溶栓研究 (TIMI)血流 3级。观察术后 1个月内严重心脏事件发生率。结果 全组病例的手术成功率为 97 0 %。支架成功植入患者的严重心脏事件发生率为 1 3 %。 19例患者 2 1处病变支架植入失败 ,其严重心脏事件发生率为 3 1 6%。年老、糖尿病、左心室功能减退、残留内膜撕裂、长支架和噻氯匹定的应用为发生严重心脏事件的危险因素。结论 成功植入冠状动脉内支架有助于减少介入性治疗时严重心脏事件的发生率。

Objective To evaluate the factors which may influence the occurrence of major adverse cardiac events (MACE) during intracoronary stenting.Methods Angioplasty and intracoronary stenting were attempted for 756 lesions in 632 patients within a 4-year study period. The success of the procedure was defined as a residual stenosis of ≤30% and thrombolysis in myocardial infarction (TIMI) flow grade 3 without major complications during peri-operative phrase. The rate of MACE during a 30-day follow-up period was recorded. Results The overall success rate was 97.0%. The MACE occurred in 1.3% of the patients who underwent successful therapy. The procedures was failed in 19 patients (21 lesions), the MACE rate was 31.6%. Older age, diabetes, impaired left ventricular function, residual dissection, longer stents and ticlopidine applicatin were significant risk factors for MACE. Conclusion The study indicated the optimal clinical and angiographic evaluation is crucial for reducing the overall occurrence of MACE during intracoronary stenting.