超越复缩:来自第二代冠状动脉支架试验的五年临床结果
Donald E Cutlip1, Amit G Chhabra, Donald S Baim
1Harvard Clinical Research Institute, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. dcutlip@hcri.harvard.edu
Circulation
|September 1, 2004
概括
在冠状动脉支架植入后,晚期临床失败主要是由其他冠状动脉血管的疾病进展驱动的,而不是支架病变的复缩. 糖尿病和多血管疾病增加了复原和非复原事件的风险.
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
- 临床试验 临床试验
背景情况:
- 冠状动脉支架植入旨在改善冠状动脉疾病后的结果.
- 支架后的早期临床失败与程序问题和复缩有关.
- 抑郁症与疾病进展的长期失败贡献仍然不清楚.
研究的目的:
- 为了研究冠状动脉支架植入后的长期临床事件率.
- 区分目标损伤事件 (残留症) 和非目标损伤事件 (疾病进展).
- 识别造后晚期临床失败的风险因素.
主要方法:
- 分析了来自第二代冠状动脉支架试验的1228名患者,随访了5年.
- 临床事件被分类为目标损伤或非目标损伤,并进一步分类为程序性,恢复性或非恢复性.
- 统计分析以确定危险率并确定独立的风险因素.
主要成果:
- 第一年的目标损伤事件率为18.3%;非目标损伤事件为12.4%.
- 一年后,年度目标损伤事件率下降至1.7%,而非目标损伤事件增加至6.3%.
- 到第五年,累积缩是20.3%,非缩事件是37.9%,总率为46.4%. 糖尿病和多血管疾病是独立的危险因素.
结论:
- 经过一年后的支架,临床结果主要受到非支架片段疾病进展的影响.
- 植入支架的病变本身在引起晚期临床事件方面表现出相对稳定.
- 其他冠状动脉的疾病进展在支架后具有显著的长期风险.
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