Nghiên cứu kết quả ngắn và trung hạn của phương pháp can thiệp động mạch vành qua da và nội khoa trong điều trị nhồi máu cơ tim cấp ở bệnh nhân trên và dưới 65 tuổi

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Tác giả: Văn Tân Nguyễn, Văn Trí Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 610 Medicine and health

Thông tin xuất bản: Y học thực hành, 2013

Mô tả vật lý: 67-71

Bộ sưu tập: Metadata

ID: 484029

 Objective: To assess the short term and intermediate term (3 years) outcomes of invasive reperfusion (PCI) and conservatively medical approaches in AMI treatment of 2 patient groups, those and 65 years old. Subjects and research method: From February 2009 to July 2012, the authors enrolled 467 in-patients with AMI treated at Cardiovascular ICU and lnterventional Unit of Ho Chi Minh city's Thong Nhat Hospital. The patients were categorized into 2 groups: the group or = 65 years old (elderly group) comprised 310 patients (66.38 percent), group 65 years old (non~lderly group) comprised 157 patients (33.62 percent). This is the cohort, prospective research. Results: Patients in group or = 65 years old received the conservatively medical approach much more frequently than the group , 65 years old (48.1 percent compared with 22.9 percent, p0.001). Conversely, patients in group 65 years old had the PCI more frequently than group or = 65 years old (71.4 percent compared with 49.3 percent, p0.001). In addition, Coronary artery bypass grafting (CABG) rate in the group 65 years old was also higher than those in group or = 65 years old (5.7 percent compared with 2.6 percent, p=0.15). The overall mortality of the research patients after discharge is 12 percent. Of these, the group treated with PCI had the mortality of 3.1 percent (n=6), much less than group only treated medically (18.4 percent, n=50), p0.001. When comparing the onlytreated-medically approach and PCI in 2 groups, the authors observed that group 65 years old when treated with medical approach and PCI had the mortality of 13.1 percent and 1.04 percent respectively (pq.001)
  the group or = 65 years old when treated with the medical approach and PCI had the mortality of 19.9 percent and 6.1 percent respectively, p0.001. The patients 65 years old and treated with PCI had a decrease in mortality of 82 percent compared with those 65 years old and treated medically with HR or = 65 years old and only treated medically have fatal risk 2.64 times greater than the patients 65 years old and only treated medically, p or = 65 years old and treated with PCI had a decrease in mortality of 53 percent compared with those 65 years old and only treated medically, p or = 65 years old is higher than group 65 years old with mortality at 6 months (18.8 percent compared with 0 percent respectively), at 12 months (11.1 percent compared with 2.9 percent), 24 months (14.7 percent compared with 2.2 percent), and 36 months (19.7 percent compared with 7.4 percent). Conclusions: The short-term and intermediate-term mortality of the group of patients or = 65 years old with AMI treated with a conservatively medical approach was higher than those 65 years old. The PCI approach decreased the risk of death compared with the medical approach in both the groups or = 65 years old and 65 years old. Reperfusion via PCI can be performed with elderly patients.
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