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目的了解非ST段抬高急性冠状动脉综合征(ACS)患者在住院当日行经皮冠状动脉介入治疗(PCI)的安全性和住院临床结果。方法 SUNDAY(Strategies for UA／NSTEMI and Delay of AngioplastY)为单中心回顾性注册研究,入选2000年1月至2002年12月3年间首次因非ST段抬高急性冠脉综合征在本院住院的1013例患者,记录患者的临床特点、治疗经过以及住院心血管事件等情况。本研究选择SUNDAY注册中冠状动脉造影后接受PCI的患者,比较当日(≤24 h)PCI和入院24 h以后行PCI的安全性和住院临床结果。结果在SUNDAY注册的1013例患者中,共有438例患者入院后接受冠状动脉造影和PCI。35例和 403例分别于入院≤24 h(当日PCI组)和24 h以后(非当日PCI组)行PCI。两组基础临床特征基本相似。当日PCI组和非当日PCI组分别在入院后(22±7)h和(142±152)h行冠状动脉造影(P<0．01),两组分别于入院后(1．0±0．0)d和(7．5±7．3)d行PCI(P<0．01),PCI成功率分别为97．1％与97．0％(P> 0．05)。完全血管重建率分别为62．9％与53．6％(P>0．05)。两组住院期间均无死亡,住院新发心肌梗死发生率分别为2．9％与1．2％(P:0．395),再次血管重建率分别为0与0．2％(P>0．05),主要不良心脏事件 (包括死亡、新发心肌梗死、再次血管重建)发生率分别为2．9％与1．5％(P>0．05)。当日PCI组的住院时间分别为(7．7±3．0)d与(15．2±9．8)d(P<0．01),住院费用分别为(6．1±2．3)万元与(6．4±3．1)万元(P=0．582)。结论非ST段抬高急性冠脉综合征患者在住院当日接受冠状动脉造影并行PCI安全可行, 其成功率较高,临床事件发生率较低,能显著缩短住院日,并有降低住院费用的趋势。
Objective To investigate the safety and hospitalization results of percutaneous coronary intervention (PCI) on non-ST-elevation acute coronary syndrome (ACS) patients on the day of hospitalization. METHODS: The SUNDAY (Strategies for UA / NSTEMI and Delay of AngioplastY) single-center retrospective registry was enrolled in this study for the first time in our hospital for non-ST-segment elevation acute coronary syndromes between January 2000 and December 2002 A total of 1013 patients were enrolled in this study. Their clinical characteristics, treatment and cardiovascular events were recorded. This study selected SUNDAY patients who underwent PCI after coronary angiography and compared the safety and hospitalization outcomes of PCI on the day of admission (≤24 h) with admission to hospital 24 h later. RESULTS Of the 1013 patients registered with SUNDAY, a total of 438 patients were admitted to hospital for coronary angiography and PCI. 35 cases and 403 cases were PCI ≤24 h (PCI group on the day) and 24 h after PCI (non-PCI group). The two groups of basic clinical features are similar. On the day of PCI, non-PCI patients underwent coronary angiography (P <0.01) after admission (22 ± 7) h and (142 ± 152) h, respectively. 0) d and (7.5 ± 7.3) d PCI (P <0.01). The PCI success rates were 97.1% and 97.0%, respectively (P> 0.05). Complete revascularization rates were 62.9% and 53.6%, respectively (P> 0.05). There was no death during hospitalization in both groups, with rates of hospital-acquired myocardial infarction of 2.9% and 1.2%, respectively (P = 0.395) and revascularization rates of 0 and 0.2% (P> 0 .05). The incidence of major adverse cardiac events (including death, new myocardial infarction, and revascularization) were 2.9% and 1.5%, respectively (P> 0.05). On the day of PCI, the hospital stay was (7.7 ± 3.0) d and (15.2 ± 9.8) days (P <0.01), and hospitalization costs were (6.1 ± 2.3) 10,000 yuan and (6.4 ± 3.1) million yuan (P = 0.582). Conclusions Patients with non-ST-elevation acute coronary syndrome who underwent coronary angiography and PCI during the hospital stay were safe and feasible. The success rate was high, the incidence of clinical events was low, the hospitalization days could be significantly shortened, and the trend of reducing hospitalization expenses .