有无心肌梗死前心绞痛行急诊PCI的近期疗效对比

目的分析伴梗死前心绞痛的急性心肌梗死(AMI)患者的临床及造影特点,并评价梗死前心绞痛对直接经皮冠状动脉介入治疗(PCI)近期疗效的影响。方法连续观察247例行直接PCI的AMI患者,根据AMI前2周内有无心绞痛分为梗死前心绞痛组和非梗死心绞痛组,分析其临床和造影特点,并评价其对直接PCI近期疗效的影响。结果梗塞死心绞痛组共107例(43．3%),比非梗死前心绞痛组年龄较大(分别为62．3和60．8岁),左室射血分数较高(60．8%比57．2%,P=0．043)。两组住院病死率无显著性差异,住院期间病死、再梗死、急诊CABG、心源性休克、术后室颤需电复律的联合终点事件亦无显著性差异(P＞0．05)。结论梗死前心绞痛对AMI直接PCI近期疗效无保护作用。

Comparison on therapeutic effects of emergency PCI for the patients with or without preinfarction angina pectoris

Objective To analyze the clinical and angiographic characteristics of AMI patients with preinfarction angina pectoris,and to evaluate the effect of primary PCI on early outcome.Methods 247 consecutive AMI patients received primary coronary angioplasty.The study population was divided into two groups according to the presense or absence of preinfarction angina,which was defined as the presense of antecedent angina within a 2-week period before the onset of AMI.Clinical and angiographic features were analyzed.Results 107 cases (107/147,43.3%) were with preinfarction angina pectoris, compared with patients without preinfarction angina group,were older (62.3 vs 60.8 years,P＜0.01),and LVEF was higher in preinfarction angina group (60.8% vs 57.2%,P=0.043).There was no significant difference in hospital mortality (2.8% vs 6.1%,P=0.30),or the combined endpoint events of death, reinfarction,emergency CABG,cardiogenic shock,or ventricular fibrillation after PCI between the two groups(14% vs 13.6%,P=1.0).Conclusion There is no protective effects of preinfarction angina on short- term curative effects in patients with AMI trested with primary PCI.