|编译服务：||心血管疾病防治||编译者：||张燕舞||编译时间：||May 22, 2018||浏 览 量：||1|
心肌炎可能使急性心肌梗塞（MI）过程复杂化，可能在MI后不久发生。 尽管心肌梗塞后心包炎通常是短暂性和自限性的，但症状并不舒服，并可能与潜在的复发性心肌缺血相混淆。 心肌梗塞后心包炎的发生率在再灌注时期之前高达20％，纤维蛋白溶解治疗后降至约5％，但主要经皮冠状动脉介入治疗（PCI）发生心包炎的发生率不详。 在2000年至2013年期间的一组以ST段抬高MI（STEMI）为标准的以色列患者中（其中三分之二的患者接受了主要再灌注治疗，主要为PCI），仅有1.2％发生MI后心包炎。 除了降低死亡率和其他主要不良心脏事件外，直接PCI还可能降低MI后心包炎的发生率。
There are scarce contemporary data regarding the incidence and prognosis of early postmyocardial infarction pericarditis (PMIP). Thus, we retrospectively analyzed 6,282 patients with ST-segment elevation myocardial infarction (STEMI) enrolled with known PMIP status in the Acute Coronary Syndrome Israeli Survey 2000 to 2013 registry. The primary outcome was the composite of all-cause mortality, nonfatal myocardial infarction, cerebrovascular event, stent thrombosis, or revascularization. The secondary outcomes were mortality and length of stay during the acute hospitalization. Overall, 76 patients with STEMI had PMIP (1.2%). PMIP incidence gradually decreased from 170 per 10,000 in 2000 to 110 per 10,000 in 2013, respectively (35% reduction, p for trend = 0.035). Patients with PMIP were younger (median 58.0 vs 61.0; p = 0.045), had less hypertension, higher cardiac biomarkers, and more frequently reduced left ventricular ejection fraction (87.0% vs 67.0%; p = 0.001). Patients with PMIP had longer time to reperfusion (225 minutes vs 183 minutes; p = 0.016) and length of stay (7.0 vs 5.0 days; p < 0.001). The composite end point occurred similarly inpatients with and without PMIP (10.5% vs 13.2%, respectively). There was no significant difference in 30-day, 1-year, and 5-year survival. In conclusion, PMIP is a relatively rare complication of STEMI in the coronary reperfusion era, portends worse short-term but not long-term outcomes, and is associated with bigger infarct size.