解码麦迪纳0.0.1分叉:所有代码都是一样的吗? 来自多中心注册表的结果
Matteo Maurina1, Maya Riche2, Omar Oliva3
1Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy; Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands.
麦迪纳0.0.1分支区有较高的重大不良心血管事件 (MACE) 和目标损伤再血管化 (TLR) 发生率. 糖尿病是这些罕见病变中3年MACE的唯一独立预测因子.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 梅迪纳0.0.1分叉代表了冠状动脉疾病的罕见和未经研究的子集.
- 对这些病变的最佳治疗策略仍在争论中,在临床实践中缺乏全面的描述.
研究的目的:
- 为了阐明麦地那0.0.1病变的技术管理.
- 评估与这些病变相关的临床结果.
- 确定主要不良心血管事件 (MACE) 的预测因素.
主要方法:
- 一个多中心国际注册表包括273名患者,其中277名患者在2017年至2022年期间接受皮肤冠状动脉干预 (PCI) 治疗.
- 进行了系统的数据收集和临床随访,主要终点为3年的MACE.
- 二级终点包括目标损伤再血管化 (TLR) 和支架血栓形成.
主要成果:
- 随访时间的中位数为1180天. 大多数病变 (84.1%) 用单个支架进行治疗,主要使用倒置临时支架 (53.6%) 或骨支架 (45.9%).
- 三年内MACE的发生率为16.9%,TLR为13.4%.
- 糖尿病被确定为3年MACE的唯一独立预测因子 (调整HR为2.35,p=0.01). 靠近优化技术的使用与MACE显著降低有关 (HR 0.28,p=0.03).
结论:
- 麦迪纳0.0.1分叉与长期的MACE和TLR率相关.
- 糖尿病是该患者队列中不良结果的主要独立风险因素.
- 遵守目前对分叉血管造形术的指导方针是不一致的,特别是对于较小的分叉和急性设置.
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