复杂的穿皮冠状动脉干预在TAVR前工作后的临床影响
Marisa Avvedimento1, Francisco Campelo-Parada2, Luis Nombela-Franco3
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Revista espanola de cardiologia (English ed.)
|May 19, 2024
概括
在过导管大动脉置换 (TAVR) 之前,复杂的穿皮冠状动脉干预 (PCI) 会增加主要心脏不良事件 (MACE) 的风险. PCI复杂性是TAVR冠状动脉疾病患者预后的关键预测因素.
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
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见手术.
- 接受TAVR治疗的患者往往有显著的冠状动脉疾病,需要皮肤冠状动脉干预 (PCI).
- 对于TAVR后的结果,PCI复杂性的影响尚不清楚.
研究的目的:
- 为了研究PCI复杂性和TAVR患者的临床结果之间的关联.
- 为了确定PCI复杂性作为TAVR后主要不良心脏事件 (MACE) 的预测因素.
主要方法:
- 针对1550名冠状动脉病患者预定接受TAVR的多中心研究.
- 复杂的PCI定义的标准包括治疗血管数量,支架,病变,分叉支架,支架长度,或慢性完全闭塞.
- 评估MACE,包括心血管死亡,心肌梗塞和重复血管化.
主要成果:
- 近30%的患者 (454/1550) 接受了复杂的PCI.
- 复杂的PCI与心脏死亡,心肌梗塞和冠状动脉再血管化的风险显著增加有关.
- 在TAVR之后,PCI复杂性独立预测了MACE (HR 1.31).
结论:
- 在冠状动脉疾病的TAVR候选人中,复杂的PCI与更高的MACE率有关.
- 在评估TAVR人群的预后时,应考虑PCI的程序复杂性.
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