JACC:经导管自膨式主动脉瓣膜(TAVR)患者的2年随访结果

2015-07-07 MedSci译 MedSci原创

    美国关于自膨胀式心脏瓣膜的关键性试验发现,患有严重的主动脉瓣狭窄的患者,手术可增加风险,使用经导管自膨式主动脉瓣膜的患者比那些用外科瓣膜治疗的患者在1年时存活率高4.9个百分点。    研究人员进行了一项长期的临床结果检查,以确认是否这种死亡受益情况是持续的。    重度主动脉瓣狭窄的并且手术会增加风险的患者被招募到此研究中。符合

美国关于自膨胀式心脏瓣膜的关键性试验发现,患有严重的主动脉瓣狭窄的患者,手术可增加风险,使用经导管自膨式主动脉瓣膜的患者比那些用外科瓣膜治疗的患者在1年时存活率高4.9个百分点。

研究人员进行了一项长期的临床结果检查,以确认是否这种死亡受益情况是持续的。

重度主动脉瓣狭窄的并且手术会增加风险的患者被招募到此研究中。符合条件的患者被随机以1:1的比例分配接受经导管自膨式主动脉瓣膜(经导管主动脉瓣置换组[TAVR]),或外科瓣膜主动脉瓣置换术(手术组)。研究人员对这些患者的2年的临床和超声心动图的结果进行了评价。

在美国的45个中心,共有797例患者随机接受分配。在接受治疗的队列中,TAVR组2年的全因死亡率(22.2%)明显低于手术组(28.6%;log rank检验P<0.05),绝对死亡风险减少6.5个百分点。在意向性治疗人群(ITT)中也发现了类似的结果(log rank检验P<0.05)。TAVR组的2年死亡率或严重卒中发生率(24.2%)明显低于手术组(32.5%;log rank检验P=0.01)。

重度主动脉瓣狭窄并会增加手术风险的患者,在2年时,与手术相比,使用具有自膨胀式TAVR的较高的存活率是持续的。

原始出处:
Michael J. Reardon, MD∗; David H. Adams, MD†; Neal S. Kleiman, MD∗; Steven J. Yakubov, MD‡; Joseph S. Coselli, MD§; G. Michael Deeb, MD‖; Thomas G. Gleason, MD¶; Joon Sup Lee, MD¶; James B. Hermiller, Jr., MD#; Stan Chetcuti, MD‖; John Heiser, MD∗∗; William Merhi, MD∗∗; George L. Zorn, III, MD††; Peter Tadros, MD††; Newell Robinson, MD‡‡; George Petrossian, MD‡‡; G. Chad Hughes, MD§§; J. Kevin Harrison, MD§§; Brijeshwar Maini, MD‖‖; Mubashir Mumtaz, MD‖‖; John V. Conte, MD¶¶; Jon R. Resar, MD¶¶; Vicken Aharonian, MD##; Thomas Pfeffer, MD##; Jae K. Oh, MD∗∗∗; Hongyan Qiao, PhD†††; Jeffrey J. Popma, MD‡‡‡,2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement,JACC,2015.7.7

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    2016-05-02 hbwxf
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objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Wed Jul 08 00:53:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2086292, encodeId=e3372086292ff, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Fri Sep 04 13:34:00 CST 2015, time=2015-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818766, encodeId=528e1818e664c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, 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topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332373, encodeId=013813323e3c8, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415002, encodeId=cf26141500288, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, 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objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Wed Jul 08 00:53:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2086292, encodeId=e3372086292ff, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Fri Sep 04 13:34:00 CST 2015, time=2015-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818766, encodeId=528e1818e664c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, 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topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332373, encodeId=013813323e3c8, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415002, encodeId=cf26141500288, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510034, encodeId=2d2b151003424, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583455, encodeId=28641583455c9, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31571, encodeId=da5e315e103, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:12:00 CST 2015, time=2015-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31488, encodeId=bfc03148805, content=有收获!, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Wed Jul 08 00:53:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
  7. 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topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332373, encodeId=013813323e3c8, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415002, encodeId=cf26141500288, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510034, encodeId=2d2b151003424, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583455, encodeId=28641583455c9, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Thu Jul 09 11:34:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31571, encodeId=da5e315e103, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed Jul 08 12:12:00 CST 2015, time=2015-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31488, encodeId=bfc03148805, content=有收获!, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Wed Jul 08 00:53:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
    2015-07-09 lsj631
  8. 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objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Wed Jul 08 00:53:00 CST 2015, time=2015-07-08, status=1, ipAttribution=)]
  9. 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    2015-07-08 huaxipanxing

    看看

    0

  10. 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    2015-07-08 保守主义

    有收获!

    0

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