在FAME 3试验中,接受FFR引导PCI或CABG的患者的性别差异
Kuniaki Takahashi1, Hisao Otsuki1, Frederik M Zimmermann2
1Stanford University School of Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford, California, USA.
JACC. Cardiovascular interventions
|December 6, 2024
概括
与冠状动脉旁路移植 (CABG) 相比,女性经过分流储备 (FFR) 引导的皮肤冠状动脉干预 (PCI) 后经历了类似的结果. 然而,在FAME 3试验中,男性通过CABG显示出比PCI更好的结果.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 以分流储备 (FFR) 为指导的穿皮冠状动脉干预 (PCI) 与当前一代药物排泄支架 (DES) 与冠状动脉旁路移植 (CABG) 在女性中的结果仍然不清楚.
- FAME 3试验提供了多血管冠状动脉疾病患者这种比较的数据.
研究的目的:
- 评估与CABG相比,使用当前的DES进行FFR引导PCI后的性别特异性临床结果.
- 分析接受这些重血管化策略的男性和女性之间主要不良心脏和脑血管事件 (MACCE) 的差异.
主要方法:
- 随机化FAME 3试验的子组分析,涉及1500名患有三血管冠状动脉疾病的患者.
- 在FFR指导PCI和CABG之间3年后的MACCE (所有原因死亡,心肌梗塞,中风,重复血管化) 的比较,按性别分层.
主要成果:
- 在PCI后,女性的MACCE率与CABG相比 (18.2%与18.1%) 类似.
- 与CABG相比,男性在PCI后患MACCE的风险更高 (19.1%对11.7%),主要是由于心肌梗塞增加和重复血管化.
- 与男性相比,女性在CABG后患MACCE的风险更高 (18.1%对11.7%).
结论:
- 在3年后,患有多血管冠状动脉疾病的女性与CABG相比,通过FFR引导的PCI实现了类似的临床结果.
- 在FAME 3试验中,与FFR指导的PCI相比,男性在CABG中表现出更好的结果.
相关概念视频
01:24Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
01:30Coronary Artery Disease III: Clinical Manifestations
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...