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JACC:冠脉搭桥手术的当代预后优于以往

2019-04-23 不详 MedSci原创

随着经皮冠脉介入治疗(PCI)技术的成熟,其预后也越来越好,但是外科治疗的预后变化情况尚不清楚。本研究的目的旨在比较评估目前接受冠脉搭桥手术(CABG)患者的预后和之前手术患者的预后。本研究对SYNTAX临床试验(2005-2007年)中的CABG患者和EXCEL临床试验(2010-2014)中的CABG患者进行了倾向性匹配分析,所有患者均有左主干冠脉疾病,伴有或不伴有多支冠脉病变。主要终点事件是

随着经皮冠脉介入治疗(PCI)技术的成熟,其预后也越来越好,但是外科治疗的预后变化情况尚不清楚。本研究的目的旨在比较评估目前接受冠脉搭桥手术(CABG)患者的预后和之前手术患者的预后。

本研究对SYNTAX临床试验(2005-2007年)中的CABG患者和EXCEL临床试验(2010-2014)中的CABG患者进行了倾向性匹配分析,所有患者均有左主干冠脉疾病,伴有或不伴有多支冠脉病变。主要终点事件是3年后的全因死亡、心梗、卒中和缺血驱动的血运重建复合事件。分析结果显示,与SYNTAX临床试验相比,EXCEL临床试验中的CABG的非体外循环更常见(29.6% vs. 15.4%; p < 0.001),且指南推荐的药物治疗使用率更高。主要终点事件在SYNTAX和EXCEL中的发生率分别是14.0%和20.9%(p = 0.008),除去心梗外,其他终点事件的发生率在EXCEL中的CABG中更低。

研究结果显示,与5-7年前的冠脉搭桥手术相比,近期的外科手术预后明显更佳。

原始出处:

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    2019-06-09 hbwxf
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    2019-04-25 docwu2019
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