摘要
目的阐述早期、晚期和极晚期冠状动脉支架内血栓形成(stent thrombosis,ST)在治疗和院内死亡率方面的不同。方法入选从2009年2月至2011年6月就诊于我院心内科最终明确ST的180例患者。根据支架植入术后事件出现的时间,即早期(≤1个月)、晚期(1-12个月)和极晚期(≥12个月)进行分层。结果早期ST 36例(20.1%)、晚期ST 34例(18.9%)和极晚期ST 110例(61.0%)。早期ST患者中,糖尿病所占的比例更高,而极晚期ST患者中,陈旧性心肌梗死或糖尿病患病率更低。同晚期(3.8%)和极晚期(3.6%)ST相比,早期ST院内死亡率明显更高(7.9%,P<0.001)。经多变量校正后,晚期和极晚期ST的院内死亡率依然较低[分别为:OR:0.53,95%CI:0.36-0.79和OR:0.58,95%CI:0.43-0.79]。结论早期、晚期和极晚期ST在临床表现和预后方面存在明显差别。在冠状动脉造影证实ST的急性冠状动脉综合征患者中。
Objective To describe differences in treatment and in-hospital mortality of early,late,and very late stent thrombosis （ST）.Methods We analyzed definite ST cases identified from February 2009 to June 2011 in our hospital.We stratified events by timing of presentation：early （≤ 1 month）,late （1 to 12 months）,or very late （≥ 12 months） following stent implantation.Results This ST cohort consisted of 36 patients with early ST （20.1％）,34 with late ST （18.9％）,and 110 with very late ST （61.0％）.Subjects with early ST had a higher prevalence of diabetes,whereas subjects with very late ST had a lower prevalence of prior myocardial infarction or diabetes.In-hospital mortality was significantly higher in early ST （7.9％,P ＜0.001） compared with late （3.8％） and very late ST （3.6％,P ＜0.001）.This lower mortality for late and very late ST persisted after multivariable adjustment.odds ratio：0.53 （95％ confidence interval CI：0.36 to 0.79） and 0.58 （95％ CI：0.43 to 0.79）,respectively.Conclusion Significant differences exist in the presentation and outcomes of early,late,and very late ST.Among patients with acute coronary syndromes who are undergoing percutaneous coronary intervention for angiographically documented ST,early ST is associated with the highest in-hospital mortality.
出处
《血栓与止血学》
2013年第5期202-204,共3页
Chinese Journal of Thrombosis and Hemostasis
关键词
支架内血栓
急性冠脉综合征
经皮冠脉介入治疗
Stent thrombosis
Acute coronary syndromes
Percutaneous coronary intervention
