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Lancet:冠状动脉旁路移植术与经皮冠状动脉介入治疗对不同类型冠心病患者死亡率的影响

2018-02-23 zhangfan MedSci原创

研究认为,对于多支冠状动脉疾病患者,冠状动脉旁路移植术对降低患者死亡率的效果优于经皮冠状动脉介入治疗,特别是对于糖尿病以及冠状动脉复杂度较高的患者

近日研究人员比较了冠状动脉旁路移植术(CABG)和经皮冠状动脉介入治疗(PCI)对冠心病患者死亡率的影响。

研究人员对截止2017年7月19日的相关文献进行综述,多支或左主干冠状动脉疾病患者参与,患者无急性心肌梗死,可以植入支架(裸金属或药物洗脱)并且随访期超过1年。研究人员使用Kaplan-Meier分析估计患者5年内的全因死亡率,利用随机效应Cox比例风险模型对比CABG和PCI对患者死亡率的影响。

总计11个临床研究,11518名患者参与本次荟萃分析,其中PCI组5753人,GABG组5765人。在平均随访3.8年内,976人死亡。患者平均SYNTAX得分为26.0,总计1798人(22.1%)得分高于33分。PCI组5年全因死亡率为11.2%,GABG组为9.2%(HR 1.20,95%,CI,1.06-1.37)。多支血管病患者介入治疗后5年死亡率差异显著(PCI组11.5% vs GABG组8.9%,HR,1.28),特别是多血管病伴糖尿病的患者(15.5% vs 10.0%; 1.48, 1.19-1.84),非糖尿病患者差异不显著(8.7 vs 8.0%),SYNTAX得分对多血管疾病干预措施具有显著影响。对于左主干冠状动脉疾病患者,干预方式对患者5年死亡率的影响不显著(PCI组10. 7% vs GABG组10.5%,HR1.07),该结果不受糖尿病以及SYNTAX得分的影响。

研究认为,对于多支冠状动脉疾病患者,冠状动脉旁路移植术对降低患者死亡率的效果优于经皮冠状动脉介入治疗,特别是对于糖尿病以及冠状动脉复杂度较高的患者。

原始出处:


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    2018-05-07 cy0324
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    2018-07-03 howi
  5. 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  7. 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    2018-05-07 jyzxjiangqin

    冠状动脉旁路移植术与经皮冠状动脉介入.

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1648937, encodeId=64fa164893e3d, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Tue Dec 18 00:19:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998937, encodeId=eb75199893ecb, content=<a href='/topic/show?id=8e2ee5200ee' target=_blank style='color:#2F92EE;'>#移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75200, encryptionId=8e2ee5200ee, topicName=移植术)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 03 18:19:00 CST 2018, time=2018-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2068822, encodeId=7bcc2068822ca, content=<a href='/topic/show?id=9da3203482c' target=_blank style='color:#2F92EE;'>#不同类型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20348, encryptionId=9da3203482c, topicName=不同类型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Jan 27 22:19:00 CST 2019, time=2019-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2018973, encodeId=4a5220189e39b, content=<a href='/topic/show?id=b2f35881810' target=_blank style='color:#2F92EE;'>#旁路移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58818, encryptionId=b2f35881810, topicName=旁路移植术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c8f4467, createdName=AspirantSuo, createdTime=Sat Jan 05 08:19:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=312764, encodeId=6181312e64af, content=冠状动脉旁路移植术与经皮冠状动脉介入., beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon May 07 06:57:31 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309345, encodeId=b2a830934596, content=冠状动脉旁路移植术., beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Apr 26 06:30:56 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297937, encodeId=0ae929e9374e, content=冠状动脉旁路移植术., beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 20 07:09:12 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294103, encodeId=a2262941038a, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 08 07:31:48 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-04-26 jyzxjiangqin

    冠状动脉旁路移植术.

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1648937, encodeId=64fa164893e3d, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Tue Dec 18 00:19:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998937, encodeId=eb75199893ecb, content=<a href='/topic/show?id=8e2ee5200ee' target=_blank style='color:#2F92EE;'>#移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75200, encryptionId=8e2ee5200ee, topicName=移植术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Mon May 07 01:19:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983567, encodeId=13b5198356e74, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Sun Apr 22 01:19:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829493, encodeId=8f72182949304, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jul 03 18:19:00 CST 2018, time=2018-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2068822, encodeId=7bcc2068822ca, content=<a href='/topic/show?id=9da3203482c' target=_blank style='color:#2F92EE;'>#不同类型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20348, encryptionId=9da3203482c, topicName=不同类型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Jan 27 22:19:00 CST 2019, time=2019-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2018973, encodeId=4a5220189e39b, content=<a href='/topic/show?id=b2f35881810' target=_blank style='color:#2F92EE;'>#旁路移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58818, encryptionId=b2f35881810, topicName=旁路移植术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c8f4467, createdName=AspirantSuo, createdTime=Sat Jan 05 08:19:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=312764, encodeId=6181312e64af, content=冠状动脉旁路移植术与经皮冠状动脉介入., beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon May 07 06:57:31 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=309345, encodeId=b2a830934596, content=冠状动脉旁路移植术., beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Apr 26 06:30:56 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297937, encodeId=0ae929e9374e, content=冠状动脉旁路移植术., beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 20 07:09:12 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294103, encodeId=a2262941038a, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 08 07:31:48 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-03-20 jyzxjiangqin

    冠状动脉旁路移植术.

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1648937, encodeId=64fa164893e3d, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Tue Dec 18 00:19:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998937, encodeId=eb75199893ecb, content=<a href='/topic/show?id=8e2ee5200ee' target=_blank style='color:#2F92EE;'>#移植术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75200, encryptionId=8e2ee5200ee, topicName=移植术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Mon May 07 01:19:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983567, encodeId=13b5198356e74, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Sun Apr 22 01:19:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829493, encodeId=8f72182949304, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, 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likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Apr 26 06:30:56 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297937, encodeId=0ae929e9374e, content=冠状动脉旁路移植术., beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 20 07:09:12 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294103, encodeId=a2262941038a, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 08 07:31:48 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-03-08 owlhealth

    不错耶.学习了

    0

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