对于血液动力学意义的左主冠状动脉疾病而言,推迟与执行的再血管化
Takayuki Warisawa1,2,3, Christopher M Cook4,5, Yousif Ahmad6
1Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan (T.W., S.D., Y.J.A.).
Circulation. Cardiovascular interventions
|June 20, 2023
概括
再血管化显著改善了稳定的左主冠状动脉疾病 (LMD) 患者的长期结果. 推迟治疗导致更多的重大心脏不良事件,而不是迅速的血管再循环.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床结果研究研究
背景情况:
- 左主冠状动脉疾病 (LMD) 经常被排除在主要试验之外,结果数据很少.
- 了解患有缺血症的显著LMD治疗的长期结果至关重要.
研究的目的:
- 为了比较稳定,生理上显著的LMD患者的长期临床结果再血管化与延期.
主要方法:
- 一个国际多中心注册中心分析了患有缺血的稳定LMD患者 (iFR ≤0.89).
- 患者被分为重血管化 (n=151) 和延期 (n=74) 组.
- 根据基线特征调整的倾向性得分匹配;主要终点是MACE (死亡,心脏病发作,缺血驱动的TVR).
主要成果:
- 在2.8年后,主要终点发生在14.9%的重血管化患者和28.4%的推迟治疗患者中 (HR 0.42,P=0.023).
- 心脏死亡/心肌梗塞在重血管化组中较低 (0.0%对8.1%,P=0.004).
- 缺血驱动的LMTVR在重血管化后显著降低 (5.4%对17.6%,HR 0.20,P=0.012).
结论:
- 再血管化显著改善了稳定的LMD患者的长期临床结果,这些患者有显著的缺血.
- 延迟治疗显著的LMD携带更高的心脏不良事件的风险.
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