低风险急性ST段抬高型心肌梗死患者早期出院的可行性分析  

Feasibility analysis of early hospital discharge of low-risk patients with ST-elevated myocardial infarction

作　　者：杨彦杰 王鸽 严研[1] 聂绍平[1] YANG Yan-jie;WANG Ge;YAN Yan;NIE Shao-ping(Coronary Heart Disease Center,Beijing Anzhen Hospital,Capital Medical University,100029 Beijing,China)

机构地区：[1]首都医科大学附属北京安贞医院心内冠心病中心,北京市100029

出　　处：《中国心血管病研究》2023年第8期680-683,共4页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金青年项目(82100260),北京市医管局“青苗”人才计划(QML20210605)。

摘　　要：目的探讨低风险急性ST段抬高型心肌梗死(STEMI)患者早期出院的可行性。方法连续入组2015年1月至2019年9月就诊于首都医科大学附属北京安贞医院急诊科、接受直接经皮冠状动脉介入治疗且Zwolle评分≤3分的STEMI患者748例。根据患者住院时长分为短期出院组(≤3 d)与非短期出院组(>3 d),并完成全部患者的1年随访。本研究主要终点为1年全因死亡的发生率,次要终点为1年不良心脑血管事件(MACE)的发生率。结果短期出院组1年病死率略高于非短期出院组,但结果无统计学意义(2.4%比1.0%,HR=1.00,95%CI 0.83~1.23,P=0.184)。两组患者MACCE事件发生率未见统计学差异(10.3%比13.2%,HR=0.97,95%CI 0.79~1.18,P>0.05)。结论低风险STEMI患者直接PCI术后早期出院安全可行。Objective To investigate the feasibility of very early discharge for low-risk patients with ST-segment elevation myocardial infarction(STEMI).Methods From January 2015 to September 2019,748 STEMI patients received primary PCI and Zwolle scores≤3 points in Beijing Anzhen Hospital were included in.According to the duration of hospitalization,126 were classified as the early discharge(within three days)and 622 as non-early discharge group(more than three days).The primary efficacy endpoint was all-cause mortality during the 1-year follow-up,and the major cardiovascular and cerebrovascular adverse events(MACE)were also collected.Results The 1-year mortality rate in the early discharge group was slightly higher than that in the non-early discharge group(2.4%vs.1.0%,P=0.184)without statistical significance,hazard ratio(HR)=1.00(0.83-1.22).A nonsignificant difference in the risk of 1-year MACCE was observed between the 2 groups(10.3%vs.13.2%,HR=0.97(0.79-1.18),P>0.05).Conclusion Early hospital discharge is feasible for the low-risk STEMI patients with successful PCI.

关 键 词：低风险 ST段抬高型心肌梗死 早期出院 

分 类 号：R542.22[医药卫生—心血管疾病]