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Am J Cardiol:共病和复发性冠脉疾病增多对PCI患者预后无显著影响?

2013-12-04 高晓方 译 医学论坛网

美国一项研究表明,在共病和复发性冠脉疾病日益增多的情况下,经皮冠脉介入(PCI)患者的5年死亡率、重复PCI率和新发病变重复PCI率未出现显著变化。论文12月2日在线发表于《美国心脏病学杂志》(Am J Cardiol)。 此项研究从1999、2004和2006年分别纳入2105、2112和2176例接受PCI治疗的患者,并在共病和治疗演进的环境下评估了冠脉疾病的死亡

美国一项研究表明,在共病和复发性冠脉疾病日益增多的情况下,经皮冠脉介入(PCI)患者的5年死亡率、重复PCI率和新发病变重复PCI率未出现显著变化。论文12月2日在线发表于《美国心脏病学杂志》(Am J Cardiol)。

此项研究从1999、2004和2006年分别纳入2105、2112和2176例接受PCI治疗的患者,并在共病和治疗演进的环境下评估了冠脉疾病的死亡和发病变化。主要转归为死亡、心梗、冠脉旁路移植(CABG)、重复PCI和重复血运重建。次要转归为依据冠脉疾病严重度和共病分层的5年时新发梗阻病变PCI以及5年死亡率和心梗率。受试者随访时间均超过5年。

结果显示,随时间推移患者更有可能伴有多重共病,并且冠脉疾病变得更为严重。尽管疾病严重度增加,但5年随访时死亡率(校正危险比[HR] 0.89)、心梗(校正HR 0.87)和重复PCI(校正HR 0.98)均无显著变化,CABG则表现为显著减少(校正HR 0.44)。伴有5种共病的患者5年死亡率为40~60%。新发病变重复PCI率轻度升高,提示在共病增多的情况下该人群的二级预防具有不足之处。

原文出处:

Anna E. Bortnick, MD, PhD, Kelly C. Epps, MD, Faith Selzer, PhD, Saif Anwaruddin, MD, Oscar C. Marroquin, MD, Vankeepuram Srinivas, MB, BS,MS, Elizabeth M. Holper, MD, Robert L. Wilensky.Five-year Follow-up of Patients Treated for Coronary Artery Disease in the Face of an Increasing Burden of Co-morbidity and Disease Complexity (From the NHLBI Dynamic Registry).Am J Cardiol.published online 02 December 2013. 


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    2014-09-06 zhmscau
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