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Circ: Cardiovascular Interventions:围手术期心肌损伤可以预测经导管主动脉瓣置换术患者的长短期死亡率

2018-11-20 xiangting MedSci原创

TAVR后的PPMI很常见,并与30天和1年死亡率密切相关。

这项研究目的是评估围手术期心肌损伤(PPMI)是否可以预测经导管主动脉瓣置换术(TAVR)患者的预后。PPMI是冠脉介入治疗后结局的有力预测因子,但其在TAVR中的影响仍不清楚。研究人员进行了系统评价和meta分析,以确定PPMI与长短期结局的关联。

进行电子检索查找报道TAVR后PPMI的研究。主要终点是30天全因死亡率,次要终点包括1年全因死亡率、神经系统事件、TAVR后起搏器植入和主动脉瓣返流。使用随机效应建模进行分析,并报告为总结优势率(OR)与95%CI。纳入了9项研究,共3442名患者(平均年龄81.0±6.6岁,女性51.2%)。在TAVR后,25.5%的患者发生PPMI。30天和1年的汇总全因死亡率分别为5.2%和18.6%。TAVR后发生PPMI与30天(OR,4.23; CI,1.95-9.19; P<0.001)和1年全因死亡率的风险显著升高相关(OR,1.77; CI,1.05-2.99; P<0.001)。同样,PPMI与TAVR后的神经系统事件(OR,2.72; CI,1.69-4.37; P<0.001)和TAVR后永久性起搏相关(OR,1.43; CI,1.02-2.00; P=0.04),但与TAVR后主动脉瓣返流的显著增多不相关(OR,1.39; CI,0.93-2.08; P=0.11)。

TAVR后的PPMI很常见,并与30天和1年死亡率密切相关。检测PPMI有助于识别后续不良事件风险最高的TAVR患者。

原始出处:

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    2019-02-13 yxch48
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2018, time=2018-11-22, status=1, ipAttribution=)]
    2019-07-16 quxin068
  6. 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