左室射血分数<35%的冠心病或应**搭桥手术!JAMA子刊加拿大回顾性研究

2020-04-11 朱朱 中国循环杂志

对左室功能严重下降(左心室射血分数<35%)的患者来说,应首先考虑心脏搭桥术,而非冠脉介入治疗。

近日发表在JAMA心脏病学子刊上的一项来自加拿大的回顾性队列研究提示,对于大多数需要血运重建、左室功能严重下降(左心室射血分数<35%)的患者来说,应首先考虑心脏搭桥术,而非冠脉介入治疗。
 
分析显示,平均5.2年随访期间,与接受心脏搭桥术的匹配患者相比,接受冠脉介入治疗的患者死亡、因心血管病死亡、发生主要不良心血管事件、再次血运重建、因心肌梗死住院、因心衰住院的风险分别增加60%、40%、1倍、2.7倍、2.2倍、50%。
 
亚组分析显示,仅前降支病变患者、完全血运重建患者、糖尿病患者均能从心脏搭桥术中获益。
 
主要不良心血管事件包括:中风、再次血运重建、因心肌梗死或心衰住院。
 
该研究纳入12 113例40~84岁(平均65岁)、左心室射血分数<35%、因冠脉病变需要首次进行血运重建的患者。
 
基于30项基线临床特征进行匹配后,冠脉介入治疗组和心脏搭桥术组均纳入2397例患者。
 
来源:Long-term Outcomes in Patients With Severely Reduced Left Ventricular Ejection Fraction Undergoing Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting. JAMA Cardiol. Published online April 8, 2020.
 

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    2020-04-11 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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