NEJM:稳定型冠心病患者FFR指导PCI或药物治疗5年预后差异研究

2018-05-24 zhangfan MedSci原创

研究认为对于显著狭窄稳定型冠心病患者根据血流储备分数指导接受PCI治疗的5年预后效果优于单纯药物治疗,而无血流动力学意义上的狭窄患者仅接受药物治疗即可获得良好的预后

近日研究人员考察了稳定型冠心病患者依据血流储备分数(FFR)接受经皮冠状动脉介入治疗(PCI)或药物治疗对预后的影响。

888名血管造影显著狭窄患者(FFR<0.80)随机接受FFR-PCI 或单纯药物治疗,研究的主要终点是死亡、心肌梗死或紧急血管重建的复合终点。

888名患者参与分组,其中PCI组447人,药物治疗组441人。5年后,PCI组主要终点事件发生率低于药物治疗组(13.9% vs 27.0%; HR, 0.46; 95% CI, 0.34-0.63; P<0.001),这种差异主要是由于紧急血管重建事件造成的,PCI组紧急血管重建率仅为6.3%而药物治疗组高达21.1% (HR, 0.27; 95% CI, 0.18-0.41)。组间死亡以及心肌梗死率差异不显著,PCI后心绞痛的缓解程度比药物治疗后更明显。

研究认为对于显著狭窄稳定型冠心病患者根据血流储备分数指导接受PCI治疗的5年预后效果优于单纯药物治疗,而无血流动力学意义上的狭窄患者仅接受药物治疗即可获得良好的预后。

原始出处:

Panagiotis Xaplanteris et al. Five-Year Outcomes with PCI Guided by Fractional Flow Reserve. N Engl J Med. May 22, 2018.

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    2018-05-29 大爰

    学习并分享!!

    0

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    2018-05-24 orangesking

    .....

    0

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    2018-05-24 wzb521zf

    一起学习学习

    0

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    2018-05-24 邓启付

    稳定型冠心病治疗是防患于未然.

    0

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