ارزیابی نتایج بالینی کوتاه مدت (داخل بیمارستانی) و بلند مدت (6 ماهه و یکساله) بیماران با PCI on vein grafts مراجعه کننده به بیمارستان قلب و عروق شهید رجایی در سال‌های 1396 تا 1398

نوع مقاله : مقاله پژوهشی

نویسندگان

1 مرکز تحقیقات قلب و عروق شهید رجایی ،مرکز آموزشی-تحقیقاتی و درمانی قلب و عروق شهید رجایی،دانشکده ی پزشکی، دانشگاه علوم پزشکی ایران،تهران.

2 ﻣﺮﻛﺰ ﺗﺤﻘﯿﻘﺎت ﻣﺪاﺧﻼت ﻗﻠﺒﻲ و ﻋﺮوﻗﻲ ، مرکز آموزشی، تحقیقاتی و درمانی قلب و عروق شهید رجایی، دانشگاه علوم پزشکی ایران.

3 دانشگاه علم و صنعت ، تهران، ایران

چکیده

مقدمه:برقراری مجدد جریان جهت درمان تنگی‌‌‌‌ عروق کرونری به دو روش؛ مداخله از راه پوست (PCI) و یا جراحی باز قابل انجام است.برای بیمارانی که قبلا به روش جراحی درمان شدند و اکنون مجدد علامت دار می‌باشند، با توجه به مورتالیتی و موربیدیتی بالاتر جراحی مجدد، روش درمانی ارجح PCI است.
روش ها:این مطالعه، یک بررسی کوهورت می‌باشد. جمعیت مورد مطالعه تمام بیماران فاقد معیارهای خروجی است که در بازه زمانی، از مهر 1396 تا مهر 1398 در بیمارستان شهید رجایی تحت PCI on SVG قرار گرفتند. در این بیماران نتایج بالینی کوتاه مدت (داخل بیمارستانی) و بلند مدت (6 ماهه و یکساله) از لحاظ میزان بروز MACE(حوادث قلبی عروقی بزرگ)بررسی شد.
یافته ها:216 بیمار در سن 39 تا 99 سال با میانگین سنی 16/9±95/65، وارد مطالعه شدند. MACE داخل بیمارستان،فقط یک مورد سکته مغزی، یک مورد MI و یک مورد هم عوارض عروقی داشتیم.طی6 ماه اول، 19 مورد مورتالیتی، 5 مورد MI ، 2 مورد نیاز به برقراری مجدد جریان بر روی همان SVG و 3 مورد نیاز به PCI بر روی سایر SVG‌های بیماران دیده شد.بعد از یک سال در مجموع 28 مورد مورتالیتی، 13 مورد MI، 7 مورد نیاز به برقراری مجدد جریان در همان SVG و 7 مورد نیاز به PCI بر روی سایر SVG‌های بیماران دیده شد. ارتباط بین میزان بروز MACE با فاکتورهای سن و بیماری مزمن کلیه دیده شد.
نتیجه گیری: MACE در بیماران مسن تر و بیماران دارای سابقه بیماری مزمن کلیه با GFR>30(نارسایی مزمن خفیف و متوسط کلیه) بیشتر اتفاق افتاد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Evaluation of short-term (in-hospital) and long-term (6 months and one year) clinical results of patients with PCI on vein grafts referred to Shahid Rajaei Cardiovascular Hospital in 2017 to 2019

نویسندگان [English]

  • elham ranjbari 1
  • zahra hosseini 2
  • mohammad mehdi peighambari 2
  • vahid ranjbari 3
1 Rajaie cardiovascular Medical and research center , school of medicine , Iran University of Medical Sciences , Tehran , Iran
2 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Iran University of Science and Technology, Tehran, Iran
چکیده [English]

Introduction:Revascularization to treat coronary artery stenosis in two ways; Percutaneous intervention (PCI) and open surgery can be performed.For patients who were previously treated with open surgery and now have symptoms again, due to the higher mortality and morbidity of re-surgery, PCI is the preferred method of treatment.
Methods:This study is a cohort.The study population includes all patients without exit criteria who were subjected to PCI on SVG in Shahid Rajaei Hospital from October 2017 to 2019. In these patients, the short-term(in-hospital) and long-term(6 months and one year) clinical results were examined in terms of the incidence of MACE(major adverse cardiovascular events).
Findings: 216 patients aged 39 to 99 years with an average of 65.95±9.16 were included in the study. In-hospital MACE, we had only one case of stroke, one case of MI, and one case of vascular complications. During the first 6 months, there were 19 cases of mortality, 5 cases of MI, 2 cases requiring reperfusion on the same SVG, and 3 cases requiring PCI, It was seen on other SVGs of the patients. After one year, a total of 28 cases of mortality, 13 cases of MI, 7 cases requiring re-establishment of flow in the same SVG and 7 cases requiring PCI were seen on other SVGs of the patients. The relationship between the incidence of MACE with the age and chronic kidney disease was seen.
Conclusion: MACE occurred more in older patients and patients with a history of chronic kidney disease with GFR>30 (mild and moderate CKD).

کلیدواژه‌ها [English]

  • Key words: MACE
  • Revascularization
  • SVG
  • PCI

مراجع

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 65، شماره 6
بهمن و اسفند 1401
صفحه 2244-2236

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