透皮冠状动脉干预在透导管大动脉置换前或之后:一个系统性审查和分析,涉及1531名患者
Rodolfo Caminiti1,2, Alfonso Ielasi1, Giampaolo Vetta3
1U.O. Cardiologia Ospedaliera, IRCCS Ospedale Galeazzi-Sant'Ambrogio, 20157 Milan, Italy.
Journal of clinical medicine
|June 27, 2024
概括
对于经过过导管大动脉置换 (TAVR) 的稳定冠状动脉疾病患者,在TAVR后进行皮肤冠状动脉干预 (PCI) 与在TAVR之前进行PCI相比,与降低的死亡率有关.
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:
- 在接受过导管大动脉置换 (TAVR) 的患者中,穿皮冠状动脉干预 (PCI) 的最佳时间尚不清楚.
- 这项研究解决了临床问题,即PCI是否应该在TAVR之前或之后进行.
研究的目的:
- 为了比较在TAVR之前接受PCI的患者与TAVR后进行PCI的患者之间的临床结果.
- 评估PCI时间对死亡率,中风和心肌梗塞 (MI) 的影响.
主要方法:
- 通过使用Medline,Embase和Cochrane数据库到2024年4月5日的数据进行了元分析.
- 包括的研究比较了与TAVR相对的PCI时间,报告死亡率,中风和MI.
- 在PROSPERO注册:CRD42023470417.7. 在此注册.
主要成果:
- 分析了3项涉及1531名患者的研究 (1240名TAVR前PCI,291名TAVR后PCI).
- 在TAVR前的PCI组中,死亡率明显高 (OR:2.48;95%CI:1.19-5.20;p=0.02).
- 对于中风 (OR:3.58;95% CI:0.70-18.15;p=0.12) 或MI (OR:0.66;95% CI:0.30-1.42;p=0.29) 两组之间没有发现显著差异.
结论:
- 对于接受TAVR的稳定冠状动脉疾病患者,TAVR后进行的PCI与较低的死亡率有关.
- 这些发现表明,在选定的患者群体中,推迟PCI到TAVR后可能有潜在的益处.
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