UNASSIGNED:很少有研究评估在经皮冠状动脉介入治疗(PCI)时代早期使用ACEI/ARB是否对血压相对较低的急性心肌梗死(AMI)患者有益。
UNASSIGNED:本研究评估了SBP<100mmHg并接受PCI的AMI患者入院24小时内使用ACEI/ARB与院内转归的关系。
UNASSIGNED:本研究基于改善中国心血管疾病护理-ACS项目,美国心脏协会和中国心脏病学会的合作注册和质量改进项目。2014年11月至2019年12月,共纳入94,623例AMI患者。其中,纳入了4,478例SBP<100mmHg且接受PCI但未在入院时临床诊断为心源性休克的AMI患者。多变量logistic回归和倾向评分匹配分析用于评估早期ACEI/ARB使用与院内主要不良心脏事件(MACEs)之间的关联。全因死亡的组合,心源性休克,还有心脏骤停.
未经证实:AMI患者,24.41%(n=1,093)在入院后24小时内服用了ACEI/ARB。早期使用ACEI/ARB的患者的MACEs发生率明显低于未使用ACEI/ARB的患者(1.67%vs.3.66%,p=0.001)。在逻辑回归分析中,早期使用ACEI/ARB与MACEs风险降低45%相关(比值比:0.55,95%CI:0.33~0.93;p=0.027).进一步的倾向评分匹配分析仍然显示,早期使用ACEI/ARB的患者的MACE发生率较低(1.96%vs.3.93%,p=0.009)。
UNASSIGNED:这项研究发现,在接受PCI的入院SBP<100mmHg的AMI患者中,早期使用ACEI/ARB与更好的住院结局相关。有必要对血压相对较低的AMI患者早期使用ACEI/ARBs进行其他研究。
UNASSIGNED: Few studies have evaluated whether acute myocardial infarction (AMI) patients with relatively low blood pressure benefit from early ACEI/ARB use in the era of percutaneous coronary intervention (PCI).
UNASSIGNED: This study evaluated the associations of ACEI/ARB use within 24 h of admission with in-hospital outcomes among AMI patients with SBP < 100 mmHg and undergoing PCI.
UNASSIGNED: This study was based on the Improving Care for Cardiovascular Disease in China-ACS project, a collaborative registry and quality improvement project of the American Heart Association and the Chinese Society of Cardiology. Between November 2014 and December 2019, a total of 94,623 patients with AMI were enrolled. Of them, 4,478 AMI patients with SBP < 100 mmHg and undergoing PCI but without clinically diagnosed cardiogenic shock at admission were included. Multivariable logistic regression and propensity score-matching analysis were used to evaluate the association between early ACEI/ARB use and in-hospital major adverse cardiac events (MACEs), a combination of all-cause death, cardiogenic shock, and cardiac arrest.
UNASSIGNED: Of AMI patients, 24.41% (n = 1,093) were prescribed ACEIs/ARBs within 24 h of admission. Patients with early ACEI/ARB use had a significantly lower rate of MACEs than those without ACEI/ARB use (1.67% vs. 3.66%, p = 0.001). In the logistic regression analysis, early ACEI/ARB use was associated with a 45% lower risk of MACEs (odds ratio: 0.55, 95% CI: 0.33-0.93; p = 0.027). Further propensity score-matching analysis still showed that patients with early ACEI/ARB use had a lower rate of MACEs (1.96% vs. 3.93%, p = 0.009).
UNASSIGNED: This study found that among AMI patients with an admission SBP < 100 mmHg undergoing PCI, early ACEI/ARB use was associated with better in-hospital outcomes. Additional studies of the early use of ACEIs/ARBs in AMI patients with relatively low blood pressure are warranted.