在接受过导管大动脉植入的患者中进行PCI
Jacob Lønborg1, Reza Jabbari1, Muhammad Sabbah1
1From the Department of Cardiology, Copenhagen University Hospital-Rigshospitalet (J.L., R.J., M. Sabbah, M.M., R.S., H.-H.T., L.H., G.B., T.J., B.T.Ö., C.G., L.S., O.D.B., T.E.), the Department of Clinical Medicine, University of Copenhagen (J.L., R.S., L.H., L.S., O.D.B., T.E.), and the Danish Heart Foundation (C.J.T.), Copenhagen, the Department of Cardiology, Odense University Hospital, Odense (K.T.V., J.E.), the Department of Cardiology, Aalborg University Hospital, Aalborg (P.F., A. Eftekhari), and the Department of Cardiology, Aarhus University Hospital, Aarhus (C.J.T., E.H.C.) - all in Denmark; the Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu (M.N., J.P.), the Heart Hospital, Tampere University Hospital, Well-being Services County of Pirkanmaa, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (O.A.K.), the Heart Center, Turku University Hospital, Turku (M. Savontaus), and the Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki (P.K., M.M.) - all in Finland; the Department of Medicine, and the Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, Stockholm (R.L., A.R.), the Department of Cardiology, Sahlgrenska University Hospital, Gothenburg (D.I., O.A.), and the Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund (S.K.) - all in Sweden; and the University of Latvia, Riga (A. Erglis).
穿皮冠状动脉干预 (PCI) 减少了经过过导管大动脉植入 (TAVI) 的患者的主要不良心脏事件. 这种方法降低了死亡,心脏病发作或紧急再血管化的风险,与两年来保守治疗相比.
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:
- 穿皮冠状动脉干预 (PCI) 在经过透气管大动脉植入 (TAVI) 的稳定冠状动脉疾病患者中所起的作用还不清楚.
- 严重的大动脉狭窄通常与冠状动脉疾病共存,需要复杂的治疗决策.
研究的目的:
- 评估PCI在患有严重症状性大动脉狭窄和显著冠状动脉疾病的患者的疗效和安全性.
- 为了比较PCI加TAVI与TAVI与冠状动脉疾病的保守治疗的策略.
主要方法:
- 一项国际随机试验将455名患有严重大动脉狭窄和冠状动脉狭窄 (FFR ≤0.80或直径狭窄≥90%) 的患者分配给PCI或保守治疗,所有患者都接受TAVI.
- 主要终点是所有原因死亡,心肌梗塞或紧急再血管化的复合结果.
- 评估了安全结果,包括出血事件和程序并发症.
主要成果:
- 随访时间中位数为2年,主要心脏不良事件发生在PCI组的26%,而保守治疗组的36% (HR,0.71;95% CI,0.51至0.99;P=0.04).
- 在PCI组 (28%) 与保守组 (20%) 相比,出血事件更频繁 (HR,1.51;95% CI,1.03至2.22).
- 在PCI组中,3%的患者出现了PCI相关的并发症.
结论:
- 在接受TAVI的冠状动脉疾病患者中,PCI与与保守管理相比,在2年随访后显著降低重大心脏不良事件的风险有关.
- 虽然PCI证明了改善的临床结果,但增加的出血事件在患者选择和管理中需要考虑.
相关概念视频
Cardiac Catheterization I: Pre-Procedure Overview
Cardiac Catheterization II: Right Heart Catheterization
Cardiac Catheterization III: Left Heart Catheterization
Cardiac Catheterization IV: Nursing Management


