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JAMA Cardiol:介入治疗低中复杂度左主干病变,与搭桥安全性相似

2017-09-15 朱柳媛 中国循环杂志

对于冠脉左主干狭窄的患者,近几十年来,心脏搭桥术一直是标准的治疗方案。

对于冠脉左主干狭窄的患者,近几十年来,心脏搭桥术一直是标准的治疗方案。

9月13日,JAMA心血管病学子刊在线发表的一项Meta分析表明,对于不太复杂(低等或中等复杂度)的冠脉左主干狭窄病变,经皮冠脉介入治疗和心脏搭桥术的整体安全性相似,但冠脉介入治疗后需要再次血运重建的风险更高一些。

无论用固定效应分析还是随机效应分析模型,其结果均显示,冠脉介入治疗和心脏搭桥术在全因死亡、心肌梗死卒中复合终点的发生风险上相似。

研究发现,冠脉介入治疗和心脏搭桥术5年全因死亡、心肌梗死和卒中复合终点的发生率分别为18.3%和16.9%。但介入治疗后再次血运重建风险比心脏搭桥术增加70%。

上述结果说明,对于不太复杂的左主干病变,介入治疗和搭桥都是血运重建的合理治疗方案。如果患者不太适合手术或者希望规避与心脏搭桥相关的并发症,冠脉介入治疗就更好。

这项Meta分析纳入4项相关的随机临床研究,共4394例患者,其平均年龄为65岁。

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    已阅

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1718531, encodeId=a4db1e1853109, content=<a href='/topic/show?id=35534e966a0' target=_blank style='color:#2F92EE;'>#左主干#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47966, encryptionId=35534e966a0, topicName=左主干)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5fa32580320, createdName=cathymary, createdTime=Wed Dec 27 14:38:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663907, encodeId=0d57166390e0c, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Mon Aug 13 04:38:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781804, encodeId=e3c41e8180453, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Apr 18 13:38:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245749, encodeId=0146245e49bc, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:38 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245748, encodeId=a31b245e48b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:28 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244441, encodeId=0d9924444143, content=这个厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Sep 16 00:13:15 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244428, encodeId=c00a24442831, content=666学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Sep 15 23:46:22 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-19 哈哈869

    学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1718531, encodeId=a4db1e1853109, content=<a href='/topic/show?id=35534e966a0' target=_blank style='color:#2F92EE;'>#左主干#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47966, encryptionId=35534e966a0, topicName=左主干)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5fa32580320, createdName=cathymary, createdTime=Wed Dec 27 14:38:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663907, encodeId=0d57166390e0c, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Mon Aug 13 04:38:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781804, encodeId=e3c41e8180453, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Apr 18 13:38:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245749, encodeId=0146245e49bc, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:38 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245748, encodeId=a31b245e48b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:28 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244441, encodeId=0d9924444143, content=这个厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Sep 16 00:13:15 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244428, encodeId=c00a24442831, content=666学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Sep 15 23:46:22 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-16 飛歌

    这个厉害了我的哥

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1718531, encodeId=a4db1e1853109, content=<a href='/topic/show?id=35534e966a0' target=_blank style='color:#2F92EE;'>#左主干#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47966, encryptionId=35534e966a0, topicName=左主干)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5fa32580320, createdName=cathymary, createdTime=Wed Dec 27 14:38:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663907, encodeId=0d57166390e0c, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Mon Aug 13 04:38:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781804, encodeId=e3c41e8180453, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Apr 18 13:38:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245749, encodeId=0146245e49bc, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:38 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245748, encodeId=a31b245e48b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Sep 19 19:47:28 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244441, encodeId=0d9924444143, content=这个厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Sep 16 00:13:15 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244428, encodeId=c00a24442831, content=666学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Sep 15 23:46:22 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-15 哈哈869

    666学习

    0

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