通过皮肤修复中枢膜以缓解二次中枢吐:系统性审查和元分析
Rasha Kaddoura1, Sanket Bhattarai2, Dina Abushanab3
1Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
The American journal of cardiology
|September 23, 2023
概括
使用MitraClip进行皮肤通透的关修复 (PMVr) 没有显示出与手术相比的生存益处,但与药物治疗相比,死亡率降低. PMVr的耐久性低于手术修复.
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
- 心脏门疾病 心脏门疾病
背景情况:
- 功能性或次要的 mitra 回吐带来了显著的发病率和死亡率风险.
- 使用MitraClip进行皮肤膜修复 (PMVr) 为传统手术提供了不那么侵入性的替代方案.
- 与手术修复和药物治疗相比,PMVr的比较有效性需要进一步研究.
研究的目的:
- 与手术修复和医疗治疗相比,系统地审查和元分析PMVr与MitraClip的有效性.
- 评估长期发病率和死亡率的结果,包括心力衰竭住院和全因死亡率.
主要方法:
- 对14项涉及2593名成年患者的研究进行了系统审查和元分析.
- 搜索了MEDLINE,EMBASE和CENTRAL数据库,使用MitraClip对PMVr进行研究.
- 使用随机效应模型将PMVr与手术修复和医疗治疗进行比较.
主要成果:
- 与手术相比,PMVr在12个月内没有维持2级+或无症状心力衰竭.
- 与手术修复相比,接受PMVr的患者心力衰竭再住院的比例更高.
- 在PMVr和手术修复之间,所有原因或心血管死亡率没有显著差异.
- 与药物治疗相比,PMVr在12个月和≥24个月内显著降低了全因死亡率.
结论:
- 在12个月或24个月后,PMVr和手术修复之间的所有原因死亡率没有差异.
- 与手术修复相比,与PMVr相比,中枢门修复的持久性较低.
- 与对 mitrale 吐的药物治疗相比,PMVr 显示死亡率显著降低.
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