贝塔阻塞剂与增加的死亡率有关,但在内血管腹腔大动脉修复 (EVAR) 后的再干预减少
Raquel Vicario-Feliciano1, Ahsan Zil-E-Ali1, Faisal Aziz1
1Division of Vascular Surgery, Heart and Vascular Institute, Pennsylvania State Milton S. Hershey Medical Center, Hershey, PA.
Annals of vascular surgery
|August 5, 2024
概括
贝塔抑制剂 (BBs) 不会减少血管内大动脉动脉瘤修复 (EVAR) 后的重新干预. 在BBs的患者有较高的死亡风险和1年后移植闭塞再干预的风险.
科学领域:
- 血管外科 血管外科
- 心血管研究研究心血管研究
- 医疗干预 医疗干预
背景情况:
- 血管内动脉瘤修复后 (EVAR) 的囊行为及其对长期存活的影响仍然不清楚.
- 有限的多中心试验调查β阻塞剂 (BBs) 对EVAR囊行为的影响.
- 以前的研究表明,BBs对一般或特定人群的腹腔大动脉动脉瘤囊回归没有好处.
研究的目的:
- 为了评估β阻塞剂 (BBs) 和EVAR后囊行为之间的关联.
- 评估BBs对EVAR后的再干预率和死亡率的影响.
主要方法:
- 从血管质量倡议 (2003-2021) 中对接受EVAR患者的分析.
- 基于在出院时使用BB的患者分层.
- 主要结局包括死亡率和30天和1年后的重新干预,并分析了重新干预的原因.
主要成果:
- 总共有50,411名患者被研究;57.3%的人使用BBs.
- 在BB和非BB组之间的总体再干预没有显著差异 (P=0.061).
- 接受BB治疗的患者对移植塞的再干预率较低 (11.77%与18.70%,P=0.002),但30天和1年死亡率较高 (P<0.001).
- 在接受BB的患者中,观察到1年死亡率的风险增加了26% (HR: 1.26 [1.10-1.41],P<0.001).
结论:
- 贝塔抑制剂 (BBs) 在EVAR后不会减少内血管再干预.
- 在BBs上的患者在EVAR后表现出更高的死亡率.
- 对动脉瘤行为的BBs理论上的好处没有得到这种大规模分析的支持.
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