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JACC：搭桥vsPCI—伴1型糖尿病心血管疾病患者治疗的选择

2017-09-16 MedSci MedSci原创

心血管T1D
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对于伴有多支血管病变的1型糖尿病（T1D）患者，搭桥手术或者经皮冠脉介入治疗（PCI）的收益哪种更大尚未阐明。本研究纳入了瑞典1995年至2013年行首次多血管重建手术的T1D患者，并通过多个数据库对患者的临床信息和预后进行全面的评估分析。最终，共纳入了683名接受搭桥手术治疗的患者和1863名接受PCI治疗的患者，经过平均10.6年时间的随访，搭桥治疗组的53%患者和PCI治疗组的45%患者死亡

对于伴有多支血管病变的1型糖尿病（T1D）患者，搭桥手术或者经皮冠脉介入治疗（PCI）的收益哪种更大尚未阐明。本研究纳入了瑞典1995年至2013年行首次多血管重建手术的T1D患者，并通过多个数据库对患者的临床信息和预后进行全面的评估分析。最终，共纳入了683名接受搭桥手术治疗的患者和1863名接受PCI治疗的患者，经过平均10.6年时间的随访，搭桥治疗组的53%患者和PCI治疗组的45%患者死亡，与搭桥治疗组相比，PCI治疗组患者的全因死亡率相似（HR： 1.14； 95% CI： 0.99 - 1.32），卒中和心衰的发生风险也相似，但是冠心病（HR： 1.45； 95% CI： 1.21 - 1.74）、心梗（HR： 1.47； 95% CI： 1.23 - 1.78）和血管再重建（HR： 5.64； 95% CI： 4.67 - 6.82）的死亡率明显更高。研究结果表明，对于伴有多支血管病变的1型糖尿病患者，PCI治疗的冠心病、心梗和血管再重建的死亡风险更高，搭桥手术也许是更好的治疗手段。原始出处：Thomas N et al.PCI Versus CABG in Patien

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    2018-05-20 12498b3em16(暂无昵称)

    #搭桥#

    0

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    2018-06-05 hmwwww

    #疾病患者#

    0

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    2017-11-07 crystal0562

    #糖尿病心血管#

    0

  4. 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href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Sep 18 14:23:00 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245069, encodeId=c29d245069a3, content=学习了受益匪浅., beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Sep 17 18:43:55 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244992, encodeId=aacb2449922e, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/20/71f2c82f2515186c4d565a27af9ac6f3.jpg, createdBy=84562001987, createdName=午后阳光, createdTime=Sun Sep 17 11:47:49 CST 2017, time=2017-09-17, status=1, ipAttribution=)]
    2018-03-02 hbwxf

    #JACC#

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244992, encodeId=aacb2449922e, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/20/71f2c82f2515186c4d565a27af9ac6f3.jpg, createdBy=84562001987, createdName=午后阳光, createdTime=Sun Sep 17 11:47:49 CST 2017, time=2017-09-17, status=1, ipAttribution=)]
    2017-09-28 1771ae4158m

    学习一下很不错

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244992, encodeId=aacb2449922e, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/20/71f2c82f2515186c4d565a27af9ac6f3.jpg, createdBy=84562001987, createdName=午后阳光, createdTime=Sun Sep 17 11:47:49 CST 2017, time=2017-09-17, status=1, ipAttribution=)]
    2017-09-19 1e10c84am36(暂无匿称)

    文章很好.值得分享

    0

  7. 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    2017-09-18 12498568m50暂无昵称

    #ACC#

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244992, encodeId=aacb2449922e, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/20/71f2c82f2515186c4d565a27af9ac6f3.jpg, createdBy=84562001987, createdName=午后阳光, createdTime=Sun Sep 17 11:47:49 CST 2017, time=2017-09-17, status=1, ipAttribution=)]
    2017-09-18 andy2090

    #血管疾病#

    0

  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244992, encodeId=aacb2449922e, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/20/71f2c82f2515186c4d565a27af9ac6f3.jpg, createdBy=84562001987, createdName=午后阳光, createdTime=Sun Sep 17 11:47:49 CST 2017, time=2017-09-17, status=1, ipAttribution=)]
    2017-09-17 131****1460

    学习了受益匪浅.

    0

  10. 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    2017-09-17 午后阳光

    继续关注

    0

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JACC：代谢正常肥胖患者的心血管疾病发生风险依旧更高

目前，对于代谢正常的肥胖患者的心血管危险因素尚未阐明。近日，在国际心血管权威杂志JACC上发表了一篇旨在评估代谢正常的肥胖患者与4种不同的心血管疾病发生之间相关性的临床研究。本研究纳入了1995年至2015年美国电子数据库的350万名研究对象，年龄均在18岁及以上，并且最开始均无心血管疾病史。通过体重指数（BMI），将所有研究对象分成不同组别，包括低体重、正常体重、超重和肥胖，并根据代谢类型分成糖

JACC：伊伐布雷定在儿童心衰患者中有效性和安全性临床研究

在成人心衰患者在，伊伐布雷定（Ivabradine）的降低心率疗法是一种较有效的治疗手段，但该药在儿童患者中的有效性尚未评估。本研究的目的就是评估伊伐布雷定在扩张型心肌病和有临床症状的慢性心衰儿童患者中的剂量-反应性，主要终点事件是在没有引起心动过缓和其他不良临床症状的情况下基础心率降低20%以上。本研究是一个随机双盲对照临床试验，随访时间为12个月。共纳入116名接受常规心衰治疗药物的患儿，被随

STROKE：心血管与大脑认知的关系

认知功能是老化的重要组成部分，其可以预测生活质量，功能独立性和制度化风险。目前，对心血管风险作用的理解进展显示，它们与认知障碍和痴呆密切相关。因为许多心血管风险是可以降低的，所以有可能维持大脑的健康并防止患者后期生活中出现痴呆。美国心脏协会（AHA）/美国中风协会旨在提供成人最佳脑健康的初步定义，以及指导如何维持大脑的健康。根据包含可以测量、监测和修改的因素，确定了成人最佳脑健康的指标。从实际因素

JACC：左房纤维化会增加房颤患者心脑血管不良事件发生风险

左房纤维化严重程度是房颤患者消融成功的关键因素之一，并与患者的卒中、高血压和心衰病史呈相关性。然而，严重的左房纤维化是否会增加房颤患者的主要心脑血管不良事件（MACCE）尚属未知。本回顾性研究纳入了2007年1月至2015年6月1228名行心脏磁共振检查左房纤维化程度的房颤患者，根据严重程度对其进行分组，并随访评估其MACCE发生的概率，包括卒中或短暂性脑缺血发作（TIA）、心梗、急性失代偿心衰或

JACC：伴有左室功能不全的捐赠者的心脏可以移植吗？

左心室收缩功能不全（LVSD）约占心脏捐赠失败原因的25%，既往的小型单中心研究显示脑死亡后的LVSD是瞬间的，一旦问题解决后心脏仍然可以进行捐赠。本研究回顾了2007年1月1日至2015年9月30日美国器官捐赠数据库捐赠者的超声心动图结果，最终选出472名原始经胸超声心动图诊断出LVSD（左室射血分数≤40%），随后又恢复正常的捐赠者，这些患者组成左室射血分数提高组，并与左室射血分数一开始就正常

Diabetes Care：不同磺酰脲类的心血管和低血糖事件的比较！

磺脲类药物与心血管不良事件和低血糖的风险增加有关，但目前仍不清楚这些风险是否随不同的药剂而发生变化。近期，一项发表在杂志Diabetes Care上的研究评估了根据胰腺特异性和药物作用持续时间分组的磺脲类药物，其导致的急性心肌梗死、缺血性卒中、心血管死亡、全因死亡率和严重低血糖风险是否不同。此项研究使用英国临床实践研究数据链，与医院数据统计数据和国家统计局数据库相关联，在1998年至2013年期间