稳定性缺血性心脏病的常规再血管化与初始医学治疗:随机试验的系统审查和元分析
在PubMed上查看摘要
概括
此摘要是机器生成的。在稳定的缺血性心脏病中,常规的再血管化并不能减少死亡,但可以降低非程序性心肌梗塞 (MI) 和不稳定的心痛. 这种方法增加了手术性心脏病发作率,长期生存益处不确定.
科学领域
- 心脏病学
- 干预心脏病学
- 临床试验
背景情况
- 稳定性缺血性心脏病 (SIHD) 的治疗通常需要重新血管.
- 重新血管化的对SIHD死亡率和心血管结果的影响仍然不确定.
- 当代试验需要对SIHD重血管化的有效性进行评估.
研究的目的
- 在SIHD患者中比较常规的再血管化与初始的保守策略.
- 评估重血管化对死亡和其他心血管结果的影响.
主要方法
- 来自PubMed,EMBASE和Cochrane中央注册的随机试验的系统审查.
- 包括14个试验中的14877名患者,平均随访时间为4. 5年.
- 分析的结局包括死亡,心肌梗塞 (MI),心力衰竭,中风,不稳定性胸痛和胸痛自由,分层使用支架和他类药物.
主要成果
- 重新血管化并没有降低死亡风险 (RR,0. 99;95% CI,0. 90-1. 09).
- 与非程序性心脏病 (RR,0. 76) 和不稳定的心痛 (RR,0. 64),但程序性心脏病 (RR,2. 48) 的增加有关.
- 整体心脏病发作,心力衰竭或中风没有显著差异;心脏病发作率增加 (RR,1. 10).
结论
- 在SIHD中,常规的再血管化不能改善存活率.
- 在减少非程序性心脏病和不稳定性胸痛方面提供好处,胸痛自由度更高.
- 更高的手术性心脏病发作率需要更长的随访时间来确定长期生存影响.
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