在功能受损患者的左侧冠状动脉再血管:皮肤冠状动脉干预与冠状动脉绕道移植相比
Amin Daoulah1, Rasha Taha Baqais2, Alwaleed Aljohar3
1Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
Kidney & blood pressure research
|July 30, 2023
概括
穿皮冠状动脉干预 (PCI) 在患有脏问题的患者中,对于左主冠状动脉疾病,显示出在医院内比冠状动脉旁路移植 (CABG) 有优势. 长期结果对于PCI和CABG都是相似的,无论功能如何.
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
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 在功能受损的患者中,左主冠状动脉疾病 (LMCA) 的最佳重血管化策略尚不清楚.
- 在这种特定患者群体中,有有限的证据可以比较皮肤穿冠状动脉干预 (PCI) 和冠状动脉旁路移植 (CABG).
研究的目的:
- 为了比较PCI与CABG在LMCA疾病治疗中的临床结果.
- 通过功能状态分层的患者 (受损与正常) 评估结果.
主要方法:
- 对14个中心的2,138名患者进行了回顾性队列研究 (2015-2019).
- 在患有功能受损的患者中,PCI与CABG的比较 (PCI:n=316,CABG:n=121).
- 在正常功能患者中,PCI与CABG的比较 (PCI:n=906,CABG:n=795).
- 主要结局:住院和随访主要心血管和脑血管不良事件 (MACCE).
主要成果:
- 与PCI相比,CABG的住院MACCE风险在受损功能组 (OR:8.13) 和正常功能组 (OR:2.59) 中显著更高.
- 在患有功能受损的患者中,PCI和CABG之间的随访MACCE没有显著差异 (HR:1.14).
- 在正常功能 (HR:1.12) 的患者中,PCI和CABG的随访MACCE率也是可比的.
结论:
- 在患有功能障碍的患者中,PCI可能比CABG在LMCA疾病的住院MACCE方面具有优势.
- 长期的MACCE结果在PCI和CABG之间是可比的,无论功能状态如何.
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