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在老年患者的非或冠状动脉旁路移植后的五年结果
Anno Diegeler1, Jochen Börgermann2, Utz Kappert3
1Herz- und Gefäß-Klinik, Bad Neustadt, Germany (A.D., M.Z., W.R.).
Circulation
|February 9, 2019
概括
在接受非抽血与抽血冠状动脉绕道移植 (CABG) 的老年患者中,五年生存率相似. 不完整的再血管化显著降低了生存率,无论手术方法如何.
科学领域:
- 心脏病学
- 心脏外科
- 老年医学
背景情况:
- 在德国的老年冠状动脉旁路移植 (GOPCABE) 试验中,在30天和1年之间没有显著的差异.
- 本研究报告了GOPCABE试验的5年随访数据.
研究的目的:
- 在75岁及以上的患者中,评估5年间的非抽动脉绕道移植 (CABG) 与抽动脉绕道移植 (CABG) 的结果.
- 评估完整或不完整的复血管化对长期生存和结果的影响.
主要方法:
- 这是一项随机试验,涉及2539名75岁以上的患者,分别接受抽血或抽血CABG.
- 主要结局:五年全因死亡率. 二次结局:死亡,心肌梗塞,重复血管化和血管化完整性的影响.
主要成果:
- 在抽外 (31%) 和抽内 (30%) CABG组之间,五年全因死亡率没有显著差异 (HR1. 03;P=0. 71).
- 死亡,心肌梗塞和重复血管化的复合结果的比例相似 (34%对33%;HR1. 03;P=0. 704).
- 在非抽血组中,不完整的再血管化更为频繁 (34%对29%;P< 0. 001),并与较低的5年生存率相关 (HR 1. 19;P=0. 04).
结论:
- 在老年患者 (≥75岁) 中,5年存活率和关键综合结局在外和内CABG中相似.
- 不完全的再血管化与5年生存率的降低有关,这与CABG手术技术无关.
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