穿皮冠状动脉干预与冠状动脉旁路移植在紧急情况下和非紧急情况下不受保护的左主血管再循环化
Amin Daoulah1, Abdulrahman H Alqahtani2, Ahmed Elmahrouk3,4
1Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, P.O. Box: 40047, Jeddah, 21499, Kingdom of Saudi Arabia. amindaoulah@yahoo.com.
European journal of medical research
|July 1, 2023
概括
穿皮冠状动脉干预 (PCI) 可能优于冠状动脉旁路移植 (CABG) 对于新出现的左主冠状动脉疾病 (LMCA). 在特定风险得分的非突发病例中,PCI也显示了益处.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 在紧急情况下,对左主冠状动脉疾病 (LMCA) 的最佳再血管化仍然存在争议.
- 穿皮冠状动脉干预 (PCI) 与冠状动脉旁路移植 (CABG) 的比较对于LMCA疾病管理至关重要.
研究的目的:
- 为了比较PCI与CABG在患有和没有新出现的LMCA疾病的患者中的结果.
- 评估住院和随访死亡率以及主要心血管和脑血管不良事件 (MACCE).
主要方法:
- 来自14个中心的2138名患者 (2015-2019) 的回顾性队列研究.
- 使用PCI与CABG进行新兴和非新兴LMCA再血管化的比较.
- 评估结果:所有原因死亡率和MACCE.
主要成果:
- 在紧急情况下,PCI显示MACCE和住院死亡率与CABG相比明显较低.
- 对于非新出现的LMCA疾病,PCI与特定的EuroSCORE和SYNTAX得分配置文件的患者中较低的MACCE和医院死亡率有关.
- 在20个月的随访中,紧急PCI显示MACCE低于CABG,所有原因死亡率没有显著差异.
结论:
- 对于新出现的LMCA再血管化,PCI可能比CABG提供优势.
- 在中级EuroSCORE和低至中级SYNTAX分数的患者中,PCI是非出现的LMCA疾病的首选选择.
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