Effect of coronary artery revascularization on in-hospital outcomes and long-term prognoses in acute myocardial infarction patients with prior ischemic stroke

ObjectiveTo 调查冠的动脉 revascularization 治疗(大车)，包括的经皮的冠的干预(一种总线标准)和冠的动脉是否绕过 grafting ( CABG )，能为有优先的 ischemic 的病人摸的尖锐心肌的梗塞( AMI )改进在里面医院和长期的结果() 387 个 AMI 病人与的 .MethodsA 总数优先在这队研究从2005年1月15日连续地被注册到2011年12月24日。所有病人被分成 CART 组(n = 204 ) 或保守的药(厘米) 组(n = 183 ) 。在里面医院 cardiocerebral 事件和在 36 个月的平均后续以后的二个组的长期的死亡被 Kaplan-Meier 幸存曲线记录并且由逻辑回归和艇长回归 model.ResultsThe 大车病人比较了更年轻(66.5 &#x000b1；9.7 年对 71.7 &#x000b1；9.7 年， P &#x0003c；0.01 ) ，有更少的非圣片断举起心肌的梗塞(11.8% 对 20.8% ， P = 0.016 ) 并且更多重脉管的冠的损害(50% 对 69.4% ， P = 0.031 ) 。当 26.2% 在 CM 组织时，在 CART 组的 cardiocerebral 事件的住院发生是 9.3%(P &#x0003c；0.01 ) 。大车显著地在 65% 减少了在里面医院 cardiocerebral 事件的风险[调整机会比率(或)= 0.35， 95% CI：0.13-0.92 ] 。在后续底， 57 个盒子(41.6%) 在厘米组死了(n = 137 ) 并且 24 个盒子(12.2%) 在大车组死了(n = 197 ) 。考克斯回归显示那辆大车减少了在 72% 的长期的死亡[调整危险比率(HR )= 0.28， 95% CI：0.06-0.46 ] ，当范畴的分析显示了时，一种总线标准和 CABG.ConclusionsCART 之间的重要差别都没在为 AMI 病人改进在里面医院和长期的预测与上有重要效果优先。

Objective To investigate whether coronary artery revascularization therapies （CART）, including percutaneous coronary intervention （PCI） and coronary artery bypass grafting （CABG）, can improve the in-hospital and long-term outcomes for acute myocardial infarction （AMI） patients with prior ischemic stroke （IS）. Methods A total of 387 AMI patients with prior IS were enrolled consecutively from January 15, 2005 to December 24, 2011 in this cohort study. All patients were categorized into the CART group （n = 204） or the conservative medications （CM） group （n = 183）. In-hospital cardiocerebral events and long-term mortality of the two groups after an average follow-up of 36 months were recorded by Kaplan-Meier survival curves and compared by Logistic regression and the Cox regression model. Results The CART patients were younger （66.5 ± 9.7 years vs. 71.7 ± 9.7 years, P 〈 0.01）, had less non-ST segment elevation myocardial infarction （11.8% vs. 20.8%, P = 0.016） and more multiple-vascular coronary lesions （50% vs. 69.4%, P = 0.031）. The hospitalization incidence of cardiocerebral events in the CART group was 9.3% while 26.2% in the CM group （P 〈 0.01）. CART significantly reduced the risk of in-hospital cardiocerebral events by 65% [adjusted odds ratio （OR） = 0.35, 95% CI： 0.13-0.92]. By the end of follow-up, 57 cases （41.6%） died in CM group （n = 137） and 24 cases （12.2%） died in CART group （n = 197）. Cox regression indicated that CART decreased the long-term mortality by 72% [adjusted hazard ratio （HR） = 0.28, 95% CI： 0.064）.46], while categorical analysis indicated no s{gnificant dif- ference between PCI and CABG. Conclusions CART has a significant effect on improving the in-hospital and long-term prognoses for AMI patients with prior IS.