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穿透导管大动脉置换后皮肤冠状动脉干预的临床结果

Carlo A Pivato^1,2, Ottavia Cozzi^1,2, Nicole Fontana^3,4

¹Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy.

European heart journal open

|September 22, 2025

概括

经过透管大动脉置换 (TAVR) 后接受皮肤冠状动脉干预 (PCI) 的患者面临更高的重大心血管不良事件 (MACE) 风险. 在TAVR冠状动脉疾病患者的PCI中,仔细选择患者至关重要.

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:

通过导管的大动脉置换 (TAVR) 越来越常见.
穿皮冠状动脉干预 (PCI) 经常在冠状动脉疾病患者中进行.
在TAVR后接受PCI的患者的预后尚不清楚.

研究的目的:

为了比较经过TAVR后接受PCI的患者的预后与没有先前TAVR接受PCI的患者的预后.
在这个人群中确定主要不良心血管事件 (MACE) 的风险因素.

主要方法:

连续PCI患者与没有先前TAVR (2008-2023) 的回顾性比较.
卡普兰-梅尔分析1年的MACE (心血管死亡或心肌梗塞).
对调整的危险比率 (HRs) 进行入平衡和加权的考克斯回归.

主要成果:

以前有TAVR (n=420) 的患者年龄较大,与没有TAVR (n=1197,3.7%) 的患者相比,1年MACE率更高 (8.7%).
在之前的TAVR组中,MACE的调整HR为2.36 (P=0.032).
较高的心血管死亡风险 (调整HR 3.12,P=0.032) 推动了MACE关联;心肌梗塞风险在调整后并不显著.

结论:

在TAVR后的PCI与MACE风险增加有关,主要是由心血管死亡驱动的.
准确的患者选择对于TAVR冠状动脉疾病患者的PCI至关重要.
需要进一步的研究,以优化对这种不断增长的患者队列的管理策略.

关键词:

大动脉狭窄症大动脉狭窄症冠状动脉疾病是一种冠状动脉疾病.这是PCI的PCI.在TAVRR中,我们可以看到.

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