慢性全闭性皮肤冠状动脉干预的地理多样性:来自PROGRESS-CTO注册表的见解
Michaella Alexandrou1, Athanasios Rempakos1, Deniz Mutlu1
1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
The Journal of invasive cardiology
|May 22, 2024
概括
接受慢性全闭性皮肤通冠状动脉干预 (CTO-PCI) 的北美患者出现了更复杂的病变和并发症. 然而,CTO-PCI技术和结果仍然与其他地区可比,成功率和主要心血管不良事件相似.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
背景情况:
- 患者个人资料,病变复杂性和慢性全封闭皮肤冠状动脉干预 (CTO-PCI) 的程序技术存在显著的变化.
- 了解这些差异对于全球优化CTO-PCI战略至关重要.
研究的目的:
- 为了比较患者和病变特征,干预技术,以及北美 (NA) 和全球其他地区之间的CTO-PCI结果.
- 识别CTO-PCI实践的区域差异及其对程序成功和安全的影响.
主要方法:
- 从PROGRESS-CTO注册表 (2017-2023) 中分析了11,503个CTO-PCI程序.
- 在NA和非NA中心之间比较患者人口统计,并发症,CTO病变复杂性 (J-CTO,PROGRESS-CTO得分) 和程序细节.
- 评估技术成功,程序成功和医院内主要不良心血管事件 (MACE).
主要成果:
- 与非NA患者相比,NA患者表现出更高的并发病率和更复杂的CTO病变.
- 反向和前级解剖和重新进入 (ADR) 技术,以及血管内超声波,在NA中更频繁地使用.
- 尽管患者个人资料和技术存在差异,但技术成功 (86.7%与86.8%) 和程序成功 (85.4%与85.8%) 在不同地区是相似的.
- 在NA (1.9%) 和非NA (1.7%) 中,住院MACE的发生率相似.
结论:
- 接受CTO-PCI的NA患者具有更大的并发症负担和更复杂的CTO病变.
- 虽然像逆行和ADR这样的特定技术在NA中更为普遍,但CTO-PCI的整体成功和安全性在全球范围内是一致的.
- 这些发现凸显了CTO-PCI策略对不同患者群体和病变复杂性的适应性.
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