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Ann Thorac Surg：冠状动脉旁路移植手术优于植入药物洗脱支架：男女有别？

2015-08-30 MedSci MedSci原创

冠状动脉旁路移植手术药物洗脱支架
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一些随机对照试验以及观察性研究已经对比冠状动脉旁路移植手术（CABG）与植入药物洗脱支架（DES）两种治疗方式患者的预后的差异，但是这些研究没有系统的调查不同性别患者预后的相对差异。我们想对比不同性别患者CABG手术和经皮冠脉植入DES两种方式的3年预后（例如死亡率，死亡率/心肌梗死/卒中，以及血管再通）的差异。招募4532女性患者（2266对CABG和DES治疗方式的患者）和11768名男性患者

一些随机对照试验以及观察性研究已经对比冠状动脉旁路移植手术（CABG）与植入药物洗脱支架（DES）两种治疗方式患者的预后的差异，但是这些研究没有系统的调查不同性别患者预后的相对差异。我们想对比不同性别患者CABG手术和经皮冠脉植入DES两种方式的3年预后（例如死亡率，死亡率/心肌梗死/卒中，以及血管再通）的差异。

招募4532女性患者（2266对CABG和DES治疗方式的患者）和11768名男性患者（5884对），根据患者多种危险因素分别配对，并且对比3年预后。

结果：植入DES男性患者和女性患者的死亡率（校正HR分别为1.28,1.22；95%CI, 分别为1.06-1.54,1.06-1.41）都显著升高，心肌梗死/死亡率/卒中发生率升高（校正HR分别为1.40,1.36; 95% CI分别为 1.19-1.64, 1.20-1.54）。在一些预选的患者亚组中发现冠脉搭桥手术的优势。这两种治疗方法，男性患者比女性患者的不利预后低。例如：男性患者CABG和DES两种干预方式的死亡率分别为 8.0% 和9.1%，女性患者的死亡率分别为11.8%和13.7%。

男性患者和女性患者，CABG手术明显优于植入DES。这种优势也存在于有高危或无高危因素的患者。

原文出处：

Hannan EL, Zhong Y, Wu C, et al. Comparison of 3-Year Outcomes for Coronary Artery Bypass Graft Surgery and Drug-Eluting Stents: Does Sex Matter? Ann Thorac Surg. 2015 Aug 18. pii: S0003-4975(15)00942-X. doi: 10.1016/j.athoracsur.2015.05.103. [Epub ahead of print]


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    2016-05-30 zhixianchen

    #洗脱支架#

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    2016-07-01 yyj062

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    2015-09-01 智慧医人

    #药物洗脱支架#

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    2015-09-01 jiyangfei

    #植入#

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