穿皮冠状动脉干预与稳定性 angina 的药物治疗:一个匹配的队列研究
Sang-Ho Jo1, Hoseob Kim2, Hyun-Jin Kim3
1Department of Internal Medicine/ Division of Cardiology, Hallym University Sacred Heart Hospital, Anyang, Korea (the Republic of) sophi5neo@gmail.com.
Heart (British Cardiac Society)
|January 29, 2024
概括
穿皮冠状动脉干预 (PCI) 与最佳医疗疗 (OMT) 并没有减少不良事件与OMT单独相比,在稳定的心脏病患者中. 在9.3年内,PCI与心肌梗塞,中风和心脏病死亡率较高有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 稳定性胸痛影响着大量人群,需要有效的长期管理策略.
- 最佳医疗疗法 (OMT) 是稳定的胸痛治疗的基石.
- 除了OMT治疗纯稳定性心痛外,穿皮冠状动脉干预 (PCI) 的作用在长期结果方面仍然存在争议.
研究的目的:
- 为了研究穿皮冠状动脉干预 (PCI) 加上最佳医疗疗 (OMT) 与单独的OMT在患有纯稳定性 angina 的患者的长期疗效.
- 为了比较两种治疗策略之间重大不良临床事件的发生率.
主要方法:
- 一项大规模的回顾性研究,使用了2006年至2010年的韩国国民保险数据.
- 接受PCI加OMT的5673名患者的倾向与接受OMT单独的5673名患者的倾向相匹配1:1.
- 患者患有纯稳定性心痛,没有先前的心肌梗塞 (MI),没有先前的PCI,随访时间为9.3年.
主要成果:
- 主要终点 (MI,中风,心脏病死亡) 在PCI组 (13.5/1000人年) 与OMT组 (11.5/1000人年;HR 1.18) 相比显著更高.
- 在PCI组中,心脏病发作和心脏病死亡的个体事件率也更高.
- 在PCI组中,复血管化和总死亡率明显高于PCI组.
结论:
- 皮肤冠状动脉干预 (PCI) 除了最佳医疗疗 (OMT) 之外,在患有纯稳定性 angina 的患者中,与重大不良临床事件的风险增加有关.
- 单独的OMT似乎是这个患者群体的更安全的长期策略.
- 这些发现表明,在没有心脏病史或之前的PCI的情况下,在稳定性胸痛患者中重新评估常规PCI使用.
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