倾向性比分匹配的比较,对整体动脉外和上冠状动脉绕道与完整的再血管化进行了比较
Shizuya Shintomi1, Satoshi Saito2, Azumi Hamasaki2
1Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku, Tokyo, Japan. shizuyashintomi@yahoo.co.jp.
Heart and vessels
|September 25, 2023
概括
在全动脉冠状动脉旁路移植 (CABG) 后的长期结果与内 (ONCAB) 和外 (OPCAB) 程序相似. 需要透析的功能衰竭成为死亡率和主要心脏和脑血管不良事件 (MACCE) 的关键风险因素.
科学领域:
- 心血管外科心血管外科
- 心脏手术研究成果 研究结果
- 进行血管移植.
背景情况:
- 关于全动脉冠状动脉旁路移植 (CABG) 的长期结果 (>10年) 和风险因素的数据有限.
- 了解内CABG (ONCAB) 和外CABG (OPCAB) 之间的差异对于患者管理至关重要.
研究的目的:
- 评估长期结果并确定死亡率和主要心脏和脑血管不良事件 (MACCE) 的风险因素.
- 为了比较全动脉ONCAB和OPCAB与完全重血管化的结果.
主要方法:
- 401名接受初级全动脉CABG的患者的回顾性队列分析 (2000年7月 - 2019年6月).
- 倾向分数匹配 (PSM) 用于比较匹配的OPCAB (n=88) 和ONCAB (n=88) 组之间的结果.
- 单变量和多变量分析确定了死亡率和MACCEs的风险因素.
主要成果:
- 在PSM后,OPCAB和ONCAB组之间没有观察到所有原因死亡率 (HR 1.04) 或MACCE发病率 (HR 1.06) 的显著差异.
- 平均随访时间为7.9±6.3年.
- 需要透析的功能衰竭是死亡率 (p<0.0001) 和MACCE (p=0.0003) 的重要危险因素.
结论:
- 完全重血管化的全动脉OPCAB和ONCAB显示了类似的长期结果.
- 需要透析的功能衰竭是全动脉CABG后不良结果的关键独立风险因素.
相关概念视频
01:29Blood Flow
Blood is pumped by the heart into the aorta, the largest artery in the body, and then into increasingly smaller arteries, arterioles, and capillaries. The velocity of blood flow decreases with increased cross-sectional blood vessel area. As blood returns to the heart through venules and veins, its velocity increases. The movement of blood is encouraged by smooth muscle in the vessel walls, the movement of skeletal muscle surrounding the vessels, and one-way valves that prevent backflow.
01:14Overview of Blood Vessels
The human cardiovascular system comprises five primary types of blood vessels: arteries, arterioles, veins, venules, and capillaries, each serving unique functions.
Arteries and Arterioles: Arteries are muscular and elastic vessels that primarily carry oxygenated blood from the heart to body tissues, except for the pulmonary artery, which carries deoxygenated blood. They have thick walls to withstand high pressure and contain a layer of muscle tissue, allowing them to expand or contract as...
Arteries and Arterioles: Arteries are muscular and elastic vessels that primarily carry oxygenated blood from the heart to body tissues, except for the pulmonary artery, which carries deoxygenated blood. They have thick walls to withstand high pressure and contain a layer of muscle tissue, allowing them to expand or contract as...