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Eur J Heart Fail:心源性休克并发急性心肌梗死的趋势

2020-02-22 xing.T MedSci原创

由此可见,并发AMI的心源性休克发生的频率已经有所降低,但是,CS(尤其是继发性CS)的死亡率也很高,尽管采用有创治疗的频率更高,但在过去的10年中并没有实质性的改善。

很少有研究描述心源性休克(CS)患者并发急性心肌梗死(AMI)的患病率、治疗和结局的最新变化。最近,心血管领域权威杂志European Journal of Heart Failure上发表了一篇研究文章,该研究的目的是分析过去10年来在CS患者中观察到并发AMI的趋势,重点是CS发生的时机(即,原发性CS、入院时CS与继发性CS、住院期间发生的CS)。

在法国进行的三个全国性注册管理机构旨在评估AMI在现实生活中的治疗和结局,其中包括连续就诊的AMI患者(n=9951),这些患者在1个月内入住重症监护病房(ICCU)。

从2005年到2015年,CS并发AMI的患病率有所下降,2005年为5.9%,患者平均年龄为74.1±12.7。2010年为4.0%,平均年龄为73.9±12.7岁,2015年为2.8%,平均年龄为71.1±15.0(P<0.001)。原发性CS(1.8%至1.0%)和继发性CS(4.1%至1.8%)均下降。随着时间的推移,CS患者的状况也发生了变化,更多的患者出现院外心脏骤停。在原发性和继发性CS中,经皮冠状动脉介入治疗的使用随着时间的推移显著增加,机械通气和心脏辅助设备的使用也随时间有所增加。在10年期间,无论是原发性CS(41.8%至37.8%)还是继发性CS(57.3%至58.8%)患者院内死亡率均保持不变。然而,原发性CS患者的1年死亡率下降(从60%降至37.8%,P=0.038),而发生继发性CS患者则保持不变(从64.5%至69.1%,P=0.731)。

由此可见,并发AMI的心源性休克发生的频率已经有所降低,但是,CS(尤其是继发性CS)的死亡率也很高,尽管采用有创治疗的频率更高,但在过去的10年中并没有实质性的改善。

原始出处:

Nadia Aissaoui.et al.Trends in cardiogenic shock complicating acute myocardial infarction.European journal of heart failure.2020.https://onlinelibrary.wiley.com/doi/10.1002/ejhf.1750

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    2020-03-13 丁鹏鹏
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    2020-02-24 zhaojie88
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    2020-02-24 slcumt
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    2020-02-24 mhm295

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