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Heart：PCI在老年ACS患者中应用减少但疗效好

2014-06-04 高晓方 译 医学论坛网

PCI老年ACS患者
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意大利一项研究表明，在老年急性冠脉综合征(ACS)患者中，经皮冠脉介入(PCI)应用随背景风险升高而减少;但对这类人群应用PCI治疗与其远期生存获益具有相关性。论文于5月26日在线发表于《心脏》(Heart)。 此项观察性队列研究共纳入698例75岁以上的ACS患者(女性358例，平均年龄83岁)，并利用经验证的死亡预测工具Silver Code(SC)对受试者的背景风险进行分层。计算PCI应用

意大利一项研究表明，在老年急性冠脉综合征(ACS)患者中，经皮冠脉介入(PCI)应用随背景风险升高而减少;但对这类人群应用PCI治疗与其远期生存获益具有相关性。论文于5月26日在线发表于《心脏》(Heart)。

此项观察性队列研究共纳入698例75岁以上的ACS患者(女性358例，平均年龄83岁)，并利用经验证的死亡预测工具Silver Code(SC)对受试者的背景风险进行分层。计算PCI应用的多变量比值比(OR)，以及依据PCI应用的1年死亡危险比(HR)。

结果显示，纳入患者中176例伴有ST段抬高型心肌梗死(STEMI)。对阳性和阴性预测因素进行校正之后，SC评分每升高1，PCI应用机率降低11%，1年死亡风险则升高10%。PCI可随SC升高而更大程度的降低1年死亡率;SC为0～3、4～6、7～10和≥11时，HR分别为0.8、0.41、0.41和0.26。

原始出处：


Di Bari M1, Balzi D2, Fracchia S1, Barchielli A2, Orso F1, Sori A3, Spini S4, Carrabba N5, Santoro GM6, Gensini GF7, Marchionni N1; For the Acute Myocardial Infarction in Florence 2 (AMI Florence-2) Working Group.Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes.Heart. 2014 May 26. pii: heartjnl-2013-305445. doi: 10.1136/heartjnl-2013-305445. [Epub ahead of print]


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1279055, encodeId=d8e512e90553e, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355864, encodeId=21b1135586495, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562239, encodeId=092d1562239fd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574965, encodeId=f57415e496511, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=)]
    2014-06-06 yaanren

    #ACS#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1279055, encodeId=d8e512e90553e, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355864, encodeId=21b1135586495, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562239, encodeId=092d1562239fd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574965, encodeId=f57415e496511, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=)]
    2014-06-06 zhaojie88

    #ART#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1279055, encodeId=d8e512e90553e, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355864, encodeId=21b1135586495, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562239, encodeId=092d1562239fd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574965, encodeId=f57415e496511, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=)]
    2014-06-06 爆笑小医

    #HEART#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1279055, encodeId=d8e512e90553e, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355864, encodeId=21b1135586495, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562239, encodeId=092d1562239fd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574965, encodeId=f57415e496511, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jun 06 04:16:00 CST 2014, time=2014-06-06, status=1, ipAttribution=)]
    2014-06-06 neurosurgeon

    #ACS患者#

    0

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