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JACC:急性心梗患者不良预后事件的预测研究

2019-08-31 不详 MedSci原创

目前,对于疑似有急性心梗(AMI)患者进行早期及准确的主要不良事件(MACE)的评估尚未达到临床要求。本研究提出假设:将临床判断和心电图联合高敏心脏肌钙蛋白(hs-cTn)的检测可以进一步提高MACE的预测效果。本研究纳入了急症疑似有AMI的患者,主要终点事件是MACE,包括全因死亡、心脏猝死、AMI、心源性休克、持续性室性心律失常和房室传导阻滞。次要终点事件是MACE+接受早期血运重建的不稳定性

目前,对于疑似有急性心梗(AMI)患者进行早期及准确的主要不良事件(MACE)的评估尚未达到临床要求。本研究提出假设:将临床判断和心电图联合高敏心脏肌钙蛋白(hs-cTn)的检测可以进一步提高MACE的预测效果。

本研究纳入了急症疑似有AMI的患者,主要终点事件是MACE,包括全因死亡、心脏猝死、AMI、心源性休克、持续性室性心律失常和房室传导阻滞。次要终点事件是MACE+接受早期血运重建的不稳定性心绞痛。最终共纳入了3123名患者,与扩展算法相比,hs-ctnt 0/1h算法对更多患者进行了排除试验,而30天的MACE发生率无明显差异。hs-ctnt 0/1h算法预测了更少的阳性患者。在30天的MACE+心绞痛预测方面,hs-ctnt 0/1h算法的阳性预测值更高。

研究结果显示,高敏心脏肌钙蛋白算法更好地平衡了预测MACE的有效性和安全性,而新的联合算法更适合MACE+心绞痛的排他预测。

原始出处:

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    2020-01-16 jyzxjiangqin

    急性心梗患者的治疗。

    0

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    2019-09-27 jyzxjiangqin

    急性心血管疾病临床治疗。

    0

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    2019-12-05 hbwxf
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    2019-09-01 天地飞扬

    学习

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肺栓塞(PE)发生率在急诊昏迷的病人中尚不清楚,本研究的目的旨在评估PE在昏迷病人中的发生率。本研究无选择地纳入了昏迷患者,对1380名(99%)患者进行了360天的随访,对1156名(83%)患者进行了720天的随访。在1397名昏迷病人中,有19名患者被检出PE(1.4%; 95%[CI]: 0.87%-2.11%),在2年的随访中,新发的PE或心血管死亡发生率为0.9% (95% CI: 0

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对于无左侧瓣膜功能障碍的孤立性三尖瓣反流(TR)患者,

盘点:JACC八月第二期研究一览

1.外科手术不会改善孤立性三尖瓣反流患者的生存率DOI: 10.1016/j.jacc.2019.04.028http://www.onlinejacc.org/content/74/6对于无左侧瓣膜功能障碍的孤立性三尖瓣反流(TR)患者,通常是非手术治疗。本研究的目的旨在评估手术对孤立性TR患者的影响。本研究纳入回顾分析了2001-2016年3276名孤立性TR成年患者,并对接受有手术治疗的患者

JACC:颈总动脉滤过器的置入可预防房颤患者的卒中发生

不适于口服抗凝药(OACs)的卒中和房颤高风险患者需要其他的卒中预防策略,一种新型的永久性线圈过滤器可以直接置入两个颈总动脉(CCA),用于捕获直径大于1.4 mm的栓塞。本CAPTURE临床试验研究的目的旨在评估置入两边CCA滤过器的可行性和安全性。本研究的患者纳入标准为:房颤患者,CHA2DS2-VASc评分≥2分,OAC不适用,CCA直径为4.8-9.8mm,且没有颈动脉狭窄>30%。经超声

JACC:左主干病变的搭桥术治疗——体外循环vs非体外循环

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