在接受选择性冠状动脉旁路手术的患者中,多次先前的穿皮冠状动脉干预的预后意义
Matthias Thielmann1, Rainer Leyh, Parwis Massoudy
1Department of Thoracic and Cardiovascular Surgery, West German Heart Center Essen, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany. matthias.thielmann@uni-essen.de
Circulation
|July 6, 2006
概括
在冠状动脉旁路移植 (CABG) 后,先前接受过多次皮肤冠状动脉干预 (PCI) 的患者面临更高的住院死亡率和主要不良心脏事件 (MACE). 这项研究证实,对于那些有多次PCI疗程史的人来说,术后风险增加.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 之前的穿皮冠状动脉干预 (PCI) 对冠状动脉旁路移植 (CABG) 后的结果的影响仍在争论中.
- 在PCI后接受CABG的患者中评估术后风险对于临床决策至关重要.
研究的目的:
- 调查之前的PCI和患者在选择性CABG后的结果之间的关联.
- 要量化死亡率和主要心脏不良事件 (MACEs) 的增加风险在经历过多次PCI疗程并接受CABG的患者中.
主要方法:
- 对2626名首次隔离选择性CABG患者 (组1) 的回顾性分析,与360名单次PCI患者 (组2) 和289名多次PCI患者 (组3) 相比.
- 进行了未调整和风险调整后勤回归分析.
- 倾向-得分匹配被用来控制群体之间的选择偏差.
主要成果:
- 未调整和风险调整的分析显示,多个PCI与增加的住院死亡率 (OR,2.24) 和MACE (OR,2.28) 有显著的关联.
- 在倾向性得分匹配后,多个PCI仍然与更高的住院死亡率 (OR,3.01) 和MACE (OR,2.31) 有着强烈的关联.
结论:
- 经过多次PCI疗程的病史显著增加了接受选择性CABG的患者的住院死亡率和MACE的术后风险.
- 这些发现突显了之前进行了广泛的PCI干预的患者的风险概况.
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