在279名患者未受保护的左主干皮穿皮再血管化后的长期临床结果
Circulation
|October 3, 2001
概括
对于未受保护的左主干 (LMT) 病变而言,穿皮冠状动脉再血管化 (PCI) 是复杂的. 死亡率的预测因素包括低射出分数和休克,但在精心挑选的低风险患者中,结果显著改善.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 临床结果研究研究
背景情况:
- 穿皮冠状动脉再血管 (PCI) 越来越多地用于未受保护的左主干 (LMT) 病变.
- 对于LMT PCI的长期成功率有所不同,需要确定结果预测因素.
研究的目的:
- 确定未受保护的LMTPCI接受的患者临床结果的预测因素.
- 在现实环境中评估LMT PCI的安全性和有效性.
主要方法:
- 分析了一系列连续的279名患者,他们在1993年至1998年间接受了LMT PCI.
- 患者数据包括并发症,手术细节和临床结果,长达1年的随访.
- 多变量分析确定了所有原因死亡率的独立预测因素.
主要成果:
- 观察到高率的并发症; 46%是不可手术或高风险的手术候选人.
- 一年发病率为所有原因死亡率的24.2%,心脏病死亡率的20.2%,心肌梗塞的9.8%.
- 独立的死亡率预测因素包括低射出分数,严重的额头吐,冲击呈现,肌素升高和严重化. 一个低风险子组 (<65岁,EF>30%,没有冲击) 的1年死亡率仅为3.4%.
结论:
- 未受保护的LMT PCI患者往往具有显著的并发症和高事件率.
- 对于精选的患者来说,PCI可以成为冠状动脉旁路移植 (CABG) 的可行的替代方案,并且适用于不可手术的患者.
- 由于治疗后的早期死亡率显著,密切跟踪至关重要.
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