PDF(Pubmed)
Abstract：
UNASSIGNED: Deferred stenting has been recognized as beneficial for patients with acute ST-segment elevation myocardial infarction (STEMI) accompanied by a high thrombus burden. Nevertheless, its efficacy and safety specifically in geriatric STEMI patients remain to be elucidated. This study aims to bridge this knowledge gap and assess the potential advantages of deferred stenting in an older patient cohort.
UNASSIGNED: In this study, 208 geriatric patients (aged ≥ 80 years) with STEMI and a high thrombus burden in the infarct-related artery (IRA) were enrolled. They were categorized into two groups: the deferred stenting group, where stent implantation was conducted after 7-8 days of continuous antithrombotic therapy, and the immediate stenting group, where stent implantation was performed immediately.
UNASSIGNED: In the deferred stenting group, the stents used were significantly larger in diameter and shorter in length compared to those in the immediate stenting group (p < 0.05). This group also exhibited a lower incidence of distal embolism in the IRA, and higher rates of the thrombolysis in myocardial infarction (TIMI) blood flow grade 3 and myocardial blush grade 3 (p < 0.05). Additionally, the left ventricular ejection fractions at the 1-year follow-up were significantly higher in the deferred stenting group than in the immediate stenting group (p < 0.05). The rate of the major adverse cardiac events in the deferred stenting group was significantly lower than in the immediate stenting groups (p < 0.05).
UNASSIGNED: Deferred stenting for geriatric patients with STEMI and high thrombus burden demonstrates significant clinical benefits. This approach not only reduces the incidence of distal embolism in the IRA, but also enhances myocardial tissue perfusion and preserves cardiac ejection function. Moreover, deferred stenting has proven to be safe in this patient population, indicating its potential as a preferred treatment strategy in such cases.
UNASSIGNED: In this study, 208 geriatric patients (aged ≥ 80 years) with STEMI and a high thrombus burden in the infarct-related artery (IRA) were enrolled. They were categorized into two groups: the deferred stenting group, where stent implantation was conducted after 7-8 days of continuous antithrombotic therapy, and the immediate stenting group, where stent implantation was performed immediately.
UNASSIGNED: In the deferred stenting group, the stents used were significantly larger in diameter and shorter in length compared to those in the immediate stenting group (p < 0.05). This group also exhibited a lower incidence of distal embolism in the IRA, and higher rates of the thrombolysis in myocardial infarction (TIMI) blood flow grade 3 and myocardial blush grade 3 (p < 0.05). Additionally, the left ventricular ejection fractions at the 1-year follow-up were significantly higher in the deferred stenting group than in the immediate stenting group (p < 0.05). The rate of the major adverse cardiac events in the deferred stenting group was significantly lower than in the immediate stenting groups (p < 0.05).
UNASSIGNED: Deferred stenting for geriatric patients with STEMI and high thrombus burden demonstrates significant clinical benefits. This approach not only reduces the incidence of distal embolism in the IRA, but also enhances myocardial tissue perfusion and preserves cardiac ejection function. Moreover, deferred stenting has proven to be safe in this patient population, indicating its potential as a preferred treatment strategy in such cases.
摘要：
■对于伴有高血栓负担的急性ST段抬高型心肌梗死（STEMI）患者，延迟支架置入已被认为是有益的。然而，其有效性和安全性,特别是在老年STEMI患者中的有效性和安全性仍有待阐明.这项研究旨在弥补这一知识差距，并评估老年患者队列中延迟支架术的潜在优势。
■在这项研究中，纳入208名患有STEMI且梗死相关动脉（IRA）血栓负荷较高的老年患者（年龄≥80岁）。他们分为两组：延迟支架组，在连续抗血栓治疗7-8天后进行支架植入，和即刻支架组，立即进行支架植入。
■在延迟支架组中，与即刻支架组相比,所使用的支架直径明显较大,长度明显较短(p<0.05).该组在IRA的远端栓塞发生率也较低，心肌梗死（TIMI）血流3级和心肌红肿3级的溶栓率较高（p<0.05）。此外,1年随访时,延迟支架组左心室射血分数显著高于即刻支架组(p<0.05).延迟支架组的主要不良心脏事件发生率明显低于立即支架组（p<0.05）。
■对于患有STEMI和高血栓负担的老年患者，延迟支架显示出显著的临床益处。这种方法不仅降低了IRA远端栓塞的发生率,而且还能增强心肌组织灌注并保留心脏射血功能。此外，延期支架术已被证明在该患者人群中是安全的，表明其在这种情况下作为首选治疗策略的潜力。
■在这项研究中，纳入208名患有STEMI且梗死相关动脉（IRA）血栓负荷较高的老年患者（年龄≥80岁）。他们分为两组：延迟支架组，在连续抗血栓治疗7-8天后进行支架植入，和即刻支架组，立即进行支架植入。
■在延迟支架组中，与即刻支架组相比,所使用的支架直径明显较大,长度明显较短(p<0.05).该组在IRA的远端栓塞发生率也较低，心肌梗死（TIMI）血流3级和心肌红肿3级的溶栓率较高（p<0.05）。此外,1年随访时,延迟支架组左心室射血分数显著高于即刻支架组(p<0.05).延迟支架组的主要不良心脏事件发生率明显低于立即支架组（p<0.05）。
■对于患有STEMI和高血栓负担的老年患者，延迟支架显示出显著的临床益处。这种方法不仅降低了IRA远端栓塞的发生率,而且还能增强心肌组织灌注并保留心脏射血功能。此外，延期支架术已被证明在该患者人群中是安全的，表明其在这种情况下作为首选治疗策略的潜力。
