多血管冠状动脉疾病患者接受手术或皮肤间干预的五年结果
Szymon Jonik1, Shigetaka Kageyama2, Kai Ninomiya2
11st Department of Cardiology, Medical University of Warsaw, Banacha 1a Str, 01-267, Warsaw, Poland. szymonjonik.wum@gmail.com.
Scientific reports
|February 8, 2024
概括
对于严重的冠状动脉疾病,冠状动脉旁路移植 (CABG) 和皮肤冠状动脉干预 (PCI) 都显示出类似的长期存活率. CABG减少了重复的血管再造,而PCI与较少的中风有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 针对多血管冠状动脉疾病 (MVD) 的最佳再血管化策略仍在调查中.
- 对比冠状动脉旁路移植 (CABG) 和穿皮冠状动脉干预 (PCI) 的长期结果的现实世界证据有限.
研究的目的:
- 为了比较5年的临床结果和严重冠状动脉疾病 (CAD) 患者治疗CABG与PCI的患者的生活质量.
- 在现实临床环境中评估不同复血管化策略的有效性.
主要方法:
- 对1035名患有严重CAD的患者进行了回顾性分析.
- 根据心脏团队的建议,患者接受了CABG (356) 或PCI (679) 治疗.
- 评估5年初级和二级终点,包括死亡率,心肌梗塞 (MI),主要心脏和脑血管不良事件 (MACCE),重复血管化 (RR) 和中风.
主要成果:
- 在5年内,CABG和PCI之间的整体死亡率或MI率没有显著差异.
- 与CABG组相比,PCI组的MACCE和RR比率更高 (P < 0.01).与CABG组相比,PCI组的MACCE和RR比率更高 (P < 0.01).
- 与PCI组相比,CABG组的中风发生率较高 (P < 0.01).
结论:
- 在现实实践中,CABG和PCI都没有在5年后续对严重的CAD表现出压倒性的优势.
- 死亡率和心脏病发作率相似;CABG与较低的RR有关,而PCI与较少的中风有关.
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