穿皮冠状动脉干预后住院和长期结果的25年趋势:单一机构的经验
Mandeep Singh1, Charanjit S Rihal, Bernard J Gersh
1Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. singh.mandeep@mayo.edu
Circulation
|May 30, 2007
概括
技术进步显著改善了穿皮冠状动脉干预 (PCI) 的结果. 尽管治疗了更生病的患者,但与早期的干预相比,最近的PCI程序显示出更高的成功率和降低的死亡率.
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
- 健康 结果 研究 研究 结果
背景情况:
- 对于长期穿皮冠状动脉干预 (PCI) 结果的有限理解与不断发展的技术.
- 需要评估医学进步对现实世界临床实践的影响.
研究的目的:
- 评估技术和药理学进步对PCI结果的长期影响.
- 为了比较PCI在25年期间的住院和长期结果.
主要方法:
- 在梅奥诊所从1979年至2004年进行的24410次PCI手术的回顾性分析.
- 患者根据干预时间段 (1979-1989,1990-1996,1996-2003,2003-2004) 分为四组.
- 对手术成功,住院死亡率,紧急绕道率和长期临床结果的比较.
主要成果:
- 随着时间的推移,手术成功率显著提高 (78%至94%),尽管患者的并发病率增加.
- 在晚期,住院死亡率和需要紧急绕道手术的需求大幅下降.
- 在最近的PCI队列中观察到随访死亡率和主要心血管不良事件的显著减少.
结论:
- 在过去的25年里,穿皮冠状动脉干预的结果明显改善.
- 技术的进步和坚持以证据为基础的医学已经导致了更好的患者结果.
- 即使在高风险患者群体中,PCI仍然是一个安全有效的程序.
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