CBS 2019
CBSMD教育中心
中 文

血流储备分数

Abstract

Recommended Article

FFR-guided multivessel stenting reduces urgent revascularization compared with infarct-related artery only stenting in ST-elevation myocardial infarction: A meta-analysis of randomized controlled trials Comparison of Accuracy of One-Use Methods for Calculating Fractional Flow Reserve by Intravascular Optical Coherence Tomography to That Determined by the Pressure-Wire Method Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease: A systematic review and meta-analysis The Utility of Contrast Medium Fractional Flow Reserve in Functional Assessment Of Coronary Disease in Daily Practice Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes Accuracy of Fractional Flow Reserve Derived From Coronary Angiography Impact of Percutaneous Revascularization on Exercise Hemodynamics in Patients With Stable Coronary Disease Post-stenting fractional flow reserve vs coronary angiography for optimisation of percutaneous coronary intervention: TARGET-FFR trial

Original ResearchEpub January 12, 2018

JOURNAL:Am J Cardiol. Article Link

Prognostic Significance of Complex Ventricular Arrhythmias Complicating ST-Segment Elevation Myocardial Infarction

omasz Podolecki; Radoslaw Lenarczyk, Jacek Kowalczyk et al. Keywords: ventricular fibrillation, ventricular tachycardia, acute myocardial infarction, percutaneous coronary intervention

ABSTRACT

The aim of the study was to assess the clinical significance of complex ventricular arrhythmias (VAs) (sustained ventricular tachycardia (sVT) and ventricular fibrillation (VF)) in patients with ST-segment elevation myocardial infarction (STEMI) depending on timing of arrhythmia. We analyzed 4, 363 consecutive STEMI-patients treated invasively between 2004 and 2014. The median follow-up was 69.6 months (range: 0–139.8 months). The study population was divided into 2 main groups: VA Group encompassed 476 (10.91 %) patients with VAs, whereas 3887 (89.09 %) subjects without VT/VF were included into the Control Group. Among VA-population, pre-reperfusion VA (34.24%; n=163) was the most common arrhythmia, whereas reperfusion-induced, early post-reperfusion and late post-reperfusion VAs were diagnosed in: 103 (21.64 %), 103 (21.64 %) and 107 (22.48 %) patients, respectively. Every type of sVT/VF complicating STEMI portended significantly worse in-hospital prognosis, however a late onset arrhythmia was associated with the highest (over 5-fold) and reperfusion-induced VA with the lowest (less than 3-fold) increase in mortality risk compared to the Control Group. On the contrary, long-term mortality was significantly increased only in subjects with late post-reperfusion and pre-reperfusion VAs compared to VA-free population (43.93% and 36.81%, respectively vs. 22.58%; p<0.001). Apart from cardiogenic shock on admission, late post-reperfusion (HR 3.39) and pre-reperfusion VAs (HR 2.76) were the strongest independent predictors of death in the analyzed population. In conclusion, one in 10 patients with STEMI treated invasively was affected by sVT/VF. The clinical impact of VAs was strongly dependent on timing of arrhythmia.