透皮冠状动脉干预后糖尿病患者的例行压力测试:POST-PCI试验
Hoyun Kim1, Do-Yoon Kang1, Jinho Lee1
1Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
接受高风险穿皮冠状动脉干预 (PCI) 的糖尿病患者面临更高的风险. 在这个人群中,与标准护理相比,例行压力测试并没有改善结果.
科学领域:
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
- 干预心脏病学 干预心脏病学
背景情况:
- 通过皮肤冠状动脉干预 (PCI) 后高风险患者的最佳后续监测尚未确定.
- 接受PCI的糖尿病患者患心血管不良事件的风险更高.
研究的目的:
- 为了比较常规功能测试与单独的标准护理,用于PCI后高风险患者的后续监测.
- 具体评估糖尿病患者常规检测的益处.
主要方法:
- 一项随机试验 (POST-PCI) 将1年后的常规功能测试与仅标准护理进行了比较.
- 随机化根据糖尿病状况进行了分层.
- 主要结局是2年后死亡,心肌梗塞或不稳定的胸痛住院的综合结果.
主要成果:
- 糖尿病患者 (38.7%) 患有更多的并发症和复杂特征,主要事件的风险增加了52%.
- 在糖尿病患者 (7.1%与7.5%) 或非糖尿病患者 (4.6%与5.1%) 中,在例行检测和标准护理之间没有观察到主要复合结果的显著差异.
- 常规检测导致血管造影和再血管化率更高,无论糖尿病状况如何.
结论:
- 经过PCI后的高风险糖尿病患者与标准护理相比,不会从常规监测压力测试中受益.
- 目前的后续策略可能需要对PCI后的糖尿病人群进行重新评估.
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