未受保护的左侧主要皮肤冠状动脉干预和临床结果的趋势
Nobuhiro Ikemura1,2,3, Yuichiro Mori4, Paul S Chan1,2
1Healthcare Institute for Innovations in Quality, University of Missouri-Kansas City.
JAMA network open
|February 23, 2026
概括
在2019-2023年期间,在日本,不受保护的左侧主要穿皮冠状动脉干预 (LM PCI) 仍然是手术中稳定的比例. 尽管患者复杂性增加,但LM PCI的风险调整后住院死亡率保持一致,支持其安全性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 不受保护的左主穿皮冠状动脉干预 (LM PCI) 是一种被公认的治疗法,用于低解剖复杂性的冠状动脉疾病.
- 最近LMPCI程序量,患者人口统计,技术和结果的趋势需要描述来确认其当代安全性.
研究的目的:
- 检查日本未受保护的LMPCI的使用和医院治疗结果的时间趋势.
- 在当前的临床实践中评估LM PCI的安全性和有效性.
主要方法:
- 一项回顾性队列研究,利用从日本皮肤冠状动脉干预注册 (2019-2023) 中前性收集的数据.
- 分析包括大约1100个具有PCI能力的机构,重点是接受未受保护的LMPCI的患者.
- 住院死亡率是主要结局,使用多变量逻辑回归分析以调整患者和程序特征.
主要成果:
- 在2019年至2023年期间,不受保护的LM PCI约占所有PCI程序的5.2%.
- 在研究期间,患者的平均年龄增加,在接受LM PCI的患者中心力衰竭的患病率增加.
- 虽然未经调整的住院死亡率显示有所增加,但风险调整后的分析显示,随着时间的推移,死亡率没有显著的变化,即使考虑到增加了辐射通道和机械循环支持的使用.
结论:
- 在日本,不受保护的LMPCI占皮肤穿透冠状动脉干预的比例很大.
- 患者复杂性增加与未调整的死亡率略有上升有关,但风险调整后的结果保持稳定.
- 这些发现支持LM PCI在当代实践中作为安全的再血管化策略的持续作用.
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