从气球辅助冠状动脉干预研究 (BCIS-1):在高风险的穿皮冠状动脉干预期间选择性气球对冲的随机,受控试验的长期死亡数据
Divaka Perera1, Rod Stables, Tim Clayton
1Cardiovascular Division, St. Thomas' Hospital Campus, Kings College London, London SE1 7EH, UK. Divaka.Perera@kcl.ac.uk
Circulation
|December 11, 2012
概括
在患有严重缺血性心肌病的患者高风险皮肤冠状动脉干预 (PCI) 期间选择性大动脉内气球 (IABP) 的使用显著降低了长期全因死亡率. 这一发现支持IABP作为高风险患者群体中有益的干预措施.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 关于选择性大动脉内气球 (IABP) 在高风险皮肤冠状动脉干预 (PCI) 期间的实用性,存在相互矛盾的证据.
- 以前的随机试验没有支持IABP的使用,但观察性研究表明减少了住院事件.
- 在这个特定的患者群体中,随机试验的长期结果数据有限.
研究的目的:
- 评估在高风险穿皮冠状动脉干预 (PCI) 期间选择性大动脉内气球 (IABP) 支持对所有原因死亡率的长期影响.
- 提供从接受PCI的严重缺血性心肌病患者的随机试验中获得的长期结果数据.
主要方法:
- 一项随机对照试验,涉及301名左心室功能障碍 (排泄分数<30%) 和严重冠状动脉疾病 (BCIS-1危险评分≥8) 的患者.
- 患者随机分配为PCI,有选择性的IABP支持 (n=151) 或没有计划的IABP支持 (n=150).
- 长期所有原因的死亡率通过国家死亡登记册被追踪了51个月的中位数.
主要成果:
- 该研究包括301名患者,平均射出分数为23.6%,平均危险得分为10.4.4.
- 随访51个月的中位数,全因死亡率在整体队列中为33%.
- 选择性IABP使用与所有原因死亡率显著降低 (42例死亡与58例死亡;危险比,0.66;P=0.039).
结论:
- 在接受PCI的严重缺血性心肌病患者中,选择性IABP使用与长期全因死亡率相对降低34%有关.
- 这项研究提供了证据,支持在高风险PCI患者中选择性IABP使用的长期益处.
- 这些发现表明,在这种特定的临床场景中,IABP具有潜在的生存优势.
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