BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS ...BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.展开更多
In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous conditi...In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.展开更多
目的对比替罗非班冠状动脉内和静脉内两种途径对老年ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术后的临床效果。方法选取2015年1月~2016年1月间住院治疗的60岁以上STEMI患者85例作为研究对象,随机分为冠状动脉组和静脉组两组...目的对比替罗非班冠状动脉内和静脉内两种途径对老年ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术后的临床效果。方法选取2015年1月~2016年1月间住院治疗的60岁以上STEMI患者85例作为研究对象,随机分为冠状动脉组和静脉组两组,两组患者经急诊确诊后均静脉给予5μg/kg替罗非班并行急诊PCI,冠状动脉组在前向血流恢复后,冠状动脉内给予注射5μg/kg替罗非班完成PCI术,静脉组直接行PCI术,对比两组患者术后的即刻心肌梗死溶栓治疗试验(TIMI)血流分级、TIMI心肌灌注TMPG血流分级、心电图ST段回落情况及校正的TIMI计帧数CTFC变化情况、不良心脏事件发生对比情况等,分析替罗非班不同给药途径的临床应用价值。结果冠状动脉组与静脉组相比,总不良心脏事件发生率差异具有统计学意义(6.7%vs.22.5%,P<0.05);冠状动脉组患者手术后的TMPG血流分级中3级(95.6%)明显高于静脉组(82.5%),TMPG血流分级中2级(4.4%)明显低于静脉组(17.5%),差异均有统计学意义(P<0.05)。两组患者术后的TMPG血流分级中3级比例(86.7%vs.67.5%)和2级比例(13.3%vs.30.0%)比较差异均有统计学意义(P<0.05)。冠状动脉组患者术后2 h ST段回落中完全回落(CR)率64.4%明显高于静脉组患者,但部分回落(PR)率和不回落(NR)率明显低于经静脉组患者,差异均具有统计学意义(P<0.05);两组患者术后的CTFC明显比较差异具有统计学意义(P<0.05)。结论替罗非班通过冠状动脉内注射给药对STEMI行PCI术的效果更佳,可有效改善患者病情,降低不良心脏事件的发生率。展开更多
文摘BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.
文摘In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.
文摘目的对比替罗非班冠状动脉内和静脉内两种途径对老年ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术后的临床效果。方法选取2015年1月~2016年1月间住院治疗的60岁以上STEMI患者85例作为研究对象,随机分为冠状动脉组和静脉组两组,两组患者经急诊确诊后均静脉给予5μg/kg替罗非班并行急诊PCI,冠状动脉组在前向血流恢复后,冠状动脉内给予注射5μg/kg替罗非班完成PCI术,静脉组直接行PCI术,对比两组患者术后的即刻心肌梗死溶栓治疗试验(TIMI)血流分级、TIMI心肌灌注TMPG血流分级、心电图ST段回落情况及校正的TIMI计帧数CTFC变化情况、不良心脏事件发生对比情况等,分析替罗非班不同给药途径的临床应用价值。结果冠状动脉组与静脉组相比,总不良心脏事件发生率差异具有统计学意义(6.7%vs.22.5%,P<0.05);冠状动脉组患者手术后的TMPG血流分级中3级(95.6%)明显高于静脉组(82.5%),TMPG血流分级中2级(4.4%)明显低于静脉组(17.5%),差异均有统计学意义(P<0.05)。两组患者术后的TMPG血流分级中3级比例(86.7%vs.67.5%)和2级比例(13.3%vs.30.0%)比较差异均有统计学意义(P<0.05)。冠状动脉组患者术后2 h ST段回落中完全回落(CR)率64.4%明显高于静脉组患者,但部分回落(PR)率和不回落(NR)率明显低于经静脉组患者,差异均具有统计学意义(P<0.05);两组患者术后的CTFC明显比较差异具有统计学意义(P<0.05)。结论替罗非班通过冠状动脉内注射给药对STEMI行PCI术的效果更佳,可有效改善患者病情,降低不良心脏事件的发生率。
