章鱼的随访:20年后的预后在随机分配给内CABG,外CABG或PCI的患者中
Yvonne Koop1, Hendrik Nathoe2, Michiel Bots3
1Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands; Dutch Heart Foundation, The Hague, the Netherlands.
International journal of cardiology
|August 4, 2024
概括
长期结果显示,在内CABG,外CABG和PCI之间没有生存差异. 然而,非抽冠状动脉旁路移植 (CABG) 患者需要的重新干预比皮肤冠状动脉干预 (PCI) 患者少.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 冠状动脉绕道移植 (CABG) 和皮肤冠状动脉干预 (PCI) 的长期结果尚未确立.
- 评估不同复血管化策略的20年再干预和死亡率至关重要.
研究的目的:
- 为了比较20年死亡率和在内CABG,外CABG和PCI的再干预结果.
- 扩大现有随机试验的随访,以评估非常长期的结果.
主要方法:
- 荷兰心脏登记,荷兰统计局和章鱼试验的数据链接.
- 在1998-2000年间随机选择的患者被纳入OctoPump (on-pump vs. off-pump CABG) 和OctoStent (PCI vs. off-pump CABG) 试验.
- 延长最初的5年随访到20年的死亡率和重新干预事件.
主要成果:
- 20年后,在内CABG (50.0%) 和外CABG (46.5%) 之间的所有原因死亡率没有显著差异.
- 在内与外CABG (HR 0.82) 或PCI与外CABG (HR 0.76) 的联合死亡率和再干预没有差异.
- 与PCI患者相比,非 CABG患者的重新干预显著减少 (HR 0.52).
结论:
- 在内CABG,外CABG和PCI之间没有观察到20年生存时间的显著差异.
- 与PCI相比,Off-pump CABG在20年内显示了与PCI相比,重新干预的显著减少.
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