静脉移植失败和冠状动脉旁路手术后后来的临床结果之间的关系
Renato D Lopes1, Rajendra H Mehta, Gail E Hafley
1Duke Clinical Research Institute, Duke University Medical Center, DUMC Box 3850, Durham, NC 27705, USA.
Circulation
|January 13, 2012
概括
在冠状动脉旁路移植手术后,静脉移植失败很常见. 虽然它增加了重复血管化的风险,但它并没有显著影响死亡率或心肌梗塞率.
科学领域:
- 心血管外科心血管外科
- 血管生物学 血管生物学
- 临床结果研究研究
背景情况:
- 静脉移植失败 (VGF) 是冠状动脉旁路移植 (CABG) 手术后的常见并发症.
- 长期临床影响的VGF仍然不完全理解.
- 这项研究调查了VGF和随后的患者结局之间的关联.
研究的目的:
- 确定静脉移植失败 (VGF) 和冠状动脉旁路移植 (CABG) 手术后的长期临床结果之间的关系.
- 评估VGF对死亡率,心肌梗塞和重复血管化的影响.
主要方法:
- 从PREVENT IV试验数据库中对1829名患者进行了回顾性分析.
- 冠状动脉血管学评估了CABG手术后1218个月的VGF.
- 临床结局 (死亡,心肌梗塞,重复血管化) 在血管造影后4年被跟踪.
主要成果:
- 在43%的患者 (787/1829) 中观察到静脉移植衰竭 (VGF).
- 患有任何VGF的患者死亡,心肌梗塞或重复血管化复合结局的发生率显著更高 (aHR,1.58;P=0.008).
- 这种增加的风险主要是由更频繁的重复血管化驱动的,死亡率或心肌梗塞率没有显著差异.
结论:
- 在冠状动脉旁路移植 (CABG) 手术后,静脉移植衰竭 (VGF) 很普遍.
- VGF与重复血管化的需求增加有关,但与死亡率或心肌梗塞的增加无关.
- 需要进一步的研究来制定减轻VGF和改善CABG患者的长期结果的策略.
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