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Int J Cardiol：非IRA ICO可增加急性再灌注STEMI患者的心肌损伤

2018-07-10 MedSci MedSci原创

IRAICOSTEMI心肌损伤
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非梗塞相关动脉（非IRA）慢性完全闭塞（CTO）患者死亡率增加的机制尚不清楚。心脏磁共振（CMR）特别适合于提供关于心肌损伤和再灌注损伤的重要机械和病理生理学信息。本研究旨在探究通过CMR评估非IRA的CTO与STR抬高心肌梗死（STEMI）患者心肌损伤之间的关系。研究共纳入791名因ST段抬高型心肌梗死（STEMI）行经皮冠状动脉介入治疗（PCI）治疗的患者，根据是否存在单支病变（SVD）、多支

非梗塞相关动脉（非IRA）慢性完全闭塞（CTO）患者死亡率增加的机制尚不清楚。心脏磁共振（CMR）特别适合于提供关于心肌损伤和再灌注损伤的重要机械和病理生理学信息。本研究旨在探究通过CMR评估非IRA的CTO与STR抬高心肌梗死（STEMI）患者心肌损伤之间的关系。

研究共纳入791名因ST段抬高型心肌梗死（STEMI）行经皮冠状动脉介入治疗（PCI）治疗的患者，根据是否存在单支病变（SVD）、多支病变（MVD）以及是否存在非梗死相关CTO将其分为：单支病变组（n=345）；多支病变不存在非梗死相关CTO，即单纯多支病变（n=372）；多支病变，存在非梗死CTO（n=74）。随访12个月对比各组心肌损伤的CMR参数及临床结局。

结果显示，与单支病变和单纯多支病变相比，多支病变并存非梗死相关CTO时的梗死面积明显较高（21% vs. 16% vs. 17%）。此外，与单支病变和单纯多支病变相比，多支病变并存非梗死相关CTO组患者的心肌挽救指数明显减少、LVEF显著降低。随访12月后发现，MVD患者并存非梗死相关CTO患者的MACE率明显高于SVD及单纯多支病变组（9.7% vs. 4.1% vs. 6.5%, P= 0.015）。

综上所述，该研究结果表明，在急性再灌注STEMI患者中，并存非梗死相关CTO与较大的心肌损伤和较高的MACE率相关。

原始出处：

Saad M, Stiermaier T, et al., Impact of chronic total occlusion in a non-infarct-related coronary artery on myocardial injury assessed by cardiac magnetic resonance imaging and prognosis in ST-elevation myocardial infarction. Int J Cardiol. 2018 Aug 15;265:251-255. doi: 10.1016/j.ijcard.2018.03.042.

评论区 (6)
#插入话题
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    2018-12-27 仁者大医

    #Cardiol#

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    2019-03-02 12498c32m68暂无昵称

    #STEMI患者#

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    2018-07-12 yangcx0915

    #心肌损伤#

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    2018-07-12 ms3046638856685384

    #损伤#

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    2018-07-12 12498bb3m92(暂无昵称)

    #STEM#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1781923, encodeId=11301e8192332, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Dec 27 08:59:00 CST 2018, time=2018-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1936728, encodeId=30021936e28ed, content=<a href='/topic/show?id=74bd16e850c' target=_blank style='color:#2F92EE;'>#STEMI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16785, encryptionId=74bd16e850c, topicName=STEMI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Sat Mar 02 07:59:00 CST 2019, time=2019-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310061, encodeId=c4321310061e4, content=<a href='/topic/show?id=ddd95126e4e' target=_blank style='color:#2F92EE;'>#心肌损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51267, encryptionId=ddd95126e4e, topicName=心肌损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4723380, createdName=yangcx0915, createdTime=Thu Jul 12 10:59:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397582, encodeId=830b139e582b9, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Thu Jul 12 10:59:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1482159, encodeId=62e914821593f, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Thu Jul 12 10:59:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330674, encodeId=23903306e4b7, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Tue Jul 10 20:49:45 CST 2018, time=2018-07-10, status=1, ipAttribution=)]
    2018-07-10 戒馋，懒，贪

    谢谢分享学习了

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