期刊文献+

无保护左主干病变不同治疗策略远期临床效果 被引量:3

Long-term clinical outcomes of different treatment strategies for unprotected left main coronary artery lesion
下载PDF
导出
摘要 目的观察无保护左主干(ULM)冠状动脉病变不同治疗策略远期临床效果。方法比较211例冠状动脉内药物洗脱支架置入术(DES)(DES组)和176例冠状动脉搭桥术(CABG)(CABG组)治疗ULM病变后远期主要心脑血管事件(MACCE)发生率。结果 DES组远期再次血运重建率明显高于CABG组,心源性病死率明显低于CABG组(P<0.05)。采用倾向性得分法分析,血运重建方式与远期MACCE、总病死、心源性病死、心肌梗死和脑卒中发生率未见明显相关(P>0.05);DES与远期再次血运重建率明显相关,风险比为3.050,95%可信区间(1.289,7.217),P<0.05。结论与DES比较,CABG治疗的ULM病变患者临床状态更复杂,冠状动脉病变更严重。DES是接受血运重建的ULM病变患者远期再次血运重建的独立预测因子。 Objective To evaluate the long-term ehnical outcomes of different treatment strategies for treating unpro- tected left main (ULM) coronary artery lesion. Methods The incidence of the mayor adverse cardiac and cerebral events (MACCE) in 211 patients which received percutaneous coronary intervention with dmg-elufing stent(DES) (DES group)and 176 patients which were given coronary artery bypass grafting(CABG) were compared. Results Compared with CABG group, the rate of repeat revascularization(RR) was higher and the rate of cardiac death was lower in the DES group( P 〈 0. 05). The correlation between the revascularization way and the rates of MACCE, total death, cardiac death, myocardial infarction, stroke was not found by propensity score ( P 〉 0.05 ). However, the DES had positive correlation with the long-term rates of repeat re- vascularization[ hazard rate = 3. 050,95% confidence interval( 1. 289,7. 217) ,P 〈 0.05 ]. Conclusion Comparing with the DES, patients with ULM disease who are treated with CABG have more severe clinic status and coronary lesions. DES is the in- dependent prediction factor of long-term RR incidence in patients with ULM lesion who are received revascularization.
出处 《新乡医学院学报》 CAS 2013年第7期530-534,共5页 Journal of Xinxiang Medical University
基金 首都医学发展科研基金(编号:2009-2074)
关键词 左主干冠状动脉 血管成形术 主要不良心脏事件 冠状动脉旁路移植术 left main coronary artery angioplasty major adverse cardiac events coronary artery bypass grafting
  • 相关文献

参考文献16

  • 1Umesh N K,Daniel T F,Gosta P,et al.Radial artery bypass graftshave an increased occurrence of angiographically severe stenosisand occlusion compared with left internal mammary arteries and sa-phenous vein grafts[J].Circulation,2004,109(17):2086-2091.
  • 2King S B3rd,Smith S C Jr,Hirshfeld J W Jr,et al.2007focusedupdate of the ACC/AHA/SCAI 2005 guideline update for percuta-neous coronary intervention:a report of the American College ofCardiology/American Heart Association Task Force on practiceguidelines[J].J Am Coll Cardiol,2008,51(2):172-209.
  • 3Caracciolo E A,Davis K B,Sopko G,et al.Comparison of surgicaland medical group survival in patients with left main coronary ar-tery disease.Long-term CASS experience[J].Circulation,1995,91(9):2325-2334.
  • 4Page B J,Kireyev D,Boden W E.The role of revascularization ver-sus medical therapy in patients with type 2 diabetes mellitus andcoronary artery disease[J].Curr Diab Rep,2010,10(1):10-15.
  • 5Valgimigli M,van Mieghem C A,Ong A T,et al.Short-and long-term clinical outcome after drug-eluting stent implantation for thepercutaneous treatment of left main coronary artery disease:insightsfrom the Rapamycin-Eluting and Taxus Stent Evaluated At Rotter-dam Cardiology Hospital registries(RESEARCH and T-SEARCH)[J].Circulation,2005,111(11):1383-1389.
  • 6Naik H,White A J,Chakravarty T,et al.A meta-analysis of3773patients treated with percutaneous coronary intervention or surgeryfor unprotected left main coronary artery stenosis[J].JACC Card-iovasc Interv,2009,2(8):739-747.
  • 7Kim Y H,Park D W,Lee S W,et al.Long-term safety and effec-tiveness of unprotected left main coronary stenting with drug-elutingstents compared with bare-metal stents[J].Circulation,2009,120(5):400-407.
  • 8Park D W,Seung K B,Kim Y H,et al.Long-term safety and effica-cy of stenting versus coronary artery bypass grafting for unprotectedleft maincoronary artery disease:5-year results from the MAIN-COMPARE(revascularization for unprotected left main coronary ar-tery stenosis:comparison of percutaneous coronary angioplasty ver-sus surgical revascularization)registry[J].J Am Coll Cardiol,2010,56(2):117-124.
  • 9Kim Y H,Park D W,Kim W J,et al.Validation of SYNTAX(syn-ergy between PCI with taxus and cardiac surgery)score for predic-tion of outcomes after unprotected left main coronary revasculariza-tion[J].JACC Cardiovasc Interv,2010,3(6):612-623.
  • 10Beijk M A,Rittersma S Z,Koch K T,et al.Long-term follow-upafter nonurgent percutaneous coronary intervention in unprotectedleft main coronary arteries[J].Catheter Cardiovasc Interv,2010,75(7):1026-1036.

二级参考文献5

  • 1Kedhi E, Joesoef K S, McFadden E, et al. Second-generation everoli- mus-eluting and paclitaxel-eluting stents in real-life practice (COM- PARE) :a randomised trial [ J ]. Lancet, 2010,375 ( 9710 ) : 201- 209.
  • 2Claessen B E, Beijk M A, Legrand V, et al. Two-year clinical, an- giographic, and intravascular ultrasound follow-up of the XIENCE V everolimus-eluting stent in the treatment of patients with de novo native coronary artery lesions:the SPIRIT II trial [ J ]. Circulation, 2009,2 ( 4 ) : 339 -347.
  • 3Serruys P W, Morice M C, Kappetein A P, et al. SYNTAX Investi- gators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease [ J ]. N Engl J Med,2009 ,360(10 ) :961-972.
  • 4Capodanno D, Salvo M E, Cincotta G, et al. Usefulness of the syn- tax score for predicting clinical outcome after percutaneous coro- nary intervention of unprotected left main coronary artery disease [ J ]. Circulation,2009,2 (4) :302-308.
  • 5TAX score as predictors of very long-term clinical outcomes in pa- tients undergoing percutaneous coronary interventions: a substudy of SIRolimus-elufing stcnt compared with pacliTAXel-eluting stent for coronary revascularization (SIRTAX) trial [ J ]. Eur Heart J, 2011,32(24) :3115-3127.

共引文献5

同被引文献38

引证文献3

二级引证文献24

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部