在TAVR+PCI与SAVR+CABG后的残留SYNTAX得分和结果:一个倾向匹配的,基于性别的比较
Max Potratz1,2, Vera Fortmeier3, Katharina Höflsauer3
1Clinic for General and Interventional Cardiology/Angiology, Herz und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany MPotratz@hdz-nrw.de.
Open heart
|October 1, 2025
概括
通过导管的大动脉置换 (TAVR) 加上穿皮冠状动脉干预 (PCI) 在余冠状动脉疾病 (CAD) 较低时 (rSS <8) 显示出更好的结果. 手术性大动脉置换 (SAVR) 加上冠状动脉旁路移植 (CABG) 的结果更多地取决于患者的风险.
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
- 心脏外科手术 心脏外科手术
背景情况:
- 大动脉狭窄 (AS) 和冠状动脉疾病 (CAD) 经常同时存在.
- 手术性大动脉置换 (SAVR) 加上冠状动脉旁路移植 (CABG) 是传统的,而跨导管大动脉置换 (TAVR) 加上穿皮冠状动脉干预 (PCI) 正在越来越多地使用.
- 最佳的重血管化策略,特别是关于CAD残留负担的最佳策略,仍然不清楚.
研究的目的:
- 研究残留SYNTAX得分 (rSS) 对AS和CAD患者的结局的影响.
- 考虑到性别差异,比较TAVR+PCI和SAVR+CABG之间的结果.
- 评估rSS在不同复血管化策略中的预后重要性.
主要方法:
- 倾向性得分匹配的队列的回顾性分析.
- 包括AS和CAD患者接受TAVR+PCI或SAVR+CABG.
- 匹配变量包括年龄,弹射率,EuroSCORE II和CAD严重程度.
主要成果:
- 剩余SYNTAX评分 (rSS) 预测了TAVR+PCI组的结果,但不是SAVR+CABG组.
- 在rSS<8时,TAVR+PCI与较低的复合终点率有关,不论性别.
- TAVR+PCI显示出安全益处:男性较少出现重大出血,女性中风率较低.
结论:
- 对rSS的预后值取决于所选择的重血管化策略.
- 实现rSS <8对于改善TAVR+PCI程序的结果至关重要.
- 在SAVR+CABG后的预后主要受到基线临床风险因素的影响.
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