南非世界杯期间STEMI 临床特点及直接PCI 的近期疗效

目的:旨在分析2010年南非世界杯(FIFA)期间接受直接经皮冠状动脉(冠脉)介入治疗(PCI)ST段抬高型心肌梗死(STEMI)的特点,揭示机体应激与STEMI的关系及PCI治疗的近期疗效。方法:连续入选2010.6.11~2010.7.13观看南非2010世界杯电视直播比赛时(后)发生急性STEMI来沈阳军区总医院就诊并行直接PCI患者39例(FIFA组),同时以2009年同期(2009.6.11~2009.7.13)因急性STEMI来我院并行直接PCI患者28例作为对照(对照组)。结果:FIFA组患者平均年龄明显低于对照组(57.6 9.7岁比63.1 11.3岁,P<0.05),且夜间发病(晚10时至次日凌晨4时)的比例明显高于对照组(69.7%比42.9%,P<0.05)。冠脉造影提示FIFA组中多支冠脉病变及侧枝循环形成患者的比例明显低于对照组(17.9%比42.9%,12.8%比39.3%;均P<0.05)。另外,FIFA组患者人均支架数明显低于对照组(1.1±0.49枚比1.4±0.62枚,P<0.05)。6个月随访结果提示,与对照组左心室射血分数(LVEF)相比,FIFA组LVEF值明显高于对照组(0.59±0.11比0.53±0.13,P<0.05)。结论:本研究提示,观看足球比赛时的机体应激和情绪波动可能促进急性心肌梗死的发生。故应针对球迷进行心血管急症预防的教育,以期降低某一特定时期急性心肌梗死的发生。

Short-term Outcomes and Characteristics of STEMI Treated by Primary Angioplasty During the South Africa 2010 FIFA World Cup

Objective: To observe the relationship between emotional or physical stress and ST-segment elevation myocardial infarction(STEMI),and short-term outcomes and characteristics of primary percutaneous coronary intervention(PCI) for STEMI during the South Afirca 2010 FIFA Word Cup.Methods: From June 11 to July 13,2010,primary PCI were performed in 39 patients with STEMI(watching the live of FIFA cup match,FIFA group) in our center.Meanwhile,the control group(28 patients with STEMI) was treated by primary PCI from June 11 to July 13,2009.The characteristic and outcomes of clinical and primary PCI for STEMI in-hospital and 6 months follow-up was analyzed between two groups.Results: The average age in FIFA group was significantly lower than that in control group(57.6 9.7yrs vs 63.1 11.3yrs,P<0.05).The percentage of patients with night time onset of STEMI was higher in FIFA group than that in control group(69.7% vs 42.9%,P<0.05).The results of angiogram showed that the percentages of multi-vessel lesions and lateral branch formation in FIFA group were significantly lower than those in control group(17.9% vs 42.9%,12.8% vs 39.3%;P<0.05,respectively).Accordingly,the mean stent number per patient in FIFA group was also lower than that in control group(1.1±0.49 vs 1.4±0.62,P<0.05).Conclusion: Our results suggested that the STEMI could be induced by watching the live of football match in patients.The stress of emotional and physical might contribute to the symptom onset.Considering that,more information about the prevention measures has to be offered for people,particularly in fans in order to reduce the cardiovascular events.