冠心病患者1次介入治疗全部完成3支血管血运重建的安全性和有效性
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2015年第3期
- 页码:
- 283-286
- 栏目:
- 临床研究
- 出版日期:
- 2015-01-11
文章信息/Info
- Title:
- Safety and efficacy of one percutaneous coronary intervention for three coronary arteries in patients with three-vessel coronary disease
- Author(s):
- ZHAO Hui-qiang; CHEN Hui; LI Dong-bao; YAO Dao-kuo; WANG Lei; LI Hong-wei
- (Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
- 关键词:
- 经皮冠状动脉腔内介入治疗; 三支血管病变; SYNTAX积分
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的:观察对冠状动脉3支血管病变患者1次全部完成3支血管血运重建的安全性和有效性。方法:2010年1月~2012年9月连续对在我科住院的52例3支血管病变患者1次介入治疗全部完成3支血管的血运重建。对该组患者的临床资料、影像资料、介入治疗情况进行总结分析；对所有患者进行院内随访和平均32个月的临床随访，观察主要心血管不良事件的发生情况。结果： 52例患者均1次经皮冠状动脉介入（PCI)术全部完成3支血管的血运重建，成功率100%。共处理靶血管156支，靶病变195个，每例3~6（3.6±0.9）个病变。Syntax积分为15~32（21±4）分，其中，≤22分38例，占73%（38/52）；23~32分14例，占27%（14/52）。随访20~52（32±9)个月，主要终点事件的发生率为2%（1/52）；次级终点事件的发生率为6%（3/52）。结论:经有选择的冠心病3支血管病变患者1次完成3支血管的PCI，是可行的，有较好的安全性和有效性。
- Abstract:
- AIM:To evaluate the safety and effect of one percutaneous coronary intervention (PCI) for three coronary arteries in patients with three-vessel coronary disease. METHODS: According to the inclusion criteria, 52 consecutive patients with three-vessel coronary disease between January 2010 and September 2012 were enrolled in this study. Three coronary arteries were completely treated by one PCI in all patients. Follow-up was conducted in all patients and major adverse cardiac events (MACE: cardiogenic death, myocardial infarction, and repeated revascularization) were calculated. RESULTS: One-time PCI was conducted in 52 patients with 195 target lesions and 156 target vessels treated by PCI, and the success rate was 100%. Mean Syntax Score of the 52 patients was 21. At 32 ± 9 months, the rate of MACE was 2%(1/52) and the secondary point events rate was 6% (3/52). CONCLUSION: One PCI for three coronary arteries is fairly safe and effective in patients with three-vessel coronary disease.
参考文献/References
[1]中华医学会心血管病学分会介入心脏病学组,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南2012(简本)[J].中华心血管病杂志,2012,40(4):271-277.
[2]Task Force on the Management of ST-segment Elevation Acute Myocardial Infarction of the European Society of Cardiology (ESC),Steg PG,James SK,et al.ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation[J].Eur Heart J, 2012, 33(20):2569-2619.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.经皮冠状动脉介入治疗指南(2009)[J].中华心血管病杂志,2009,37(1):4-24.
[4]Daemen J,Kuck KH,Macaya C,et al.Multivessel coronary revascularization in patients with and without diabetes mellitus: 3-year follow-up of the ARTS-II (Arterial Revascularization Therapies Study-Part II) trial[J].J Am Coll Cardiol,2008,52(24):1957-1967.
[5]Hannan EL,Wu C,Walford G,et al.Drug-eluting stents vs coronary-artery bypass grafting in multivessel coronary disease[J].N Engl J Med,2008,358(4):331-341.
[6] Serruys PW,Morice MC,Kappetein AP,et al.Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease[J].N Engl J Med,2009,360(10):961-972.
[7]Kappetein AP,Feldman TE,Mack MJ,et al.Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease:3-year follow-up of the SYNTAX trial[J].Eur Heart J,2011,32(17):2125-2134.
[8]Tamburino C,Angiolillo DJ,Capranzano P,et al.Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents[J].Catheter Cardiovasc Interv,2008,72(4):448-456.
[9]Nikolsky E,Gruberg L,Patil CV,et al.Percutaneous coronary interventions in diabetic patients: is complete revascularization important?[J].J Invasive Cardiol,2004,16(3):102-106.
[10]Hannan EL,Samadashvili Z,Walford G,et al.Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease[J].JACC Cardiovasc Interv,2010,3(1):22-31.
[11]Widimsky P,Holmes DR.How to treat patients with ST-elevation acute myocardial infarction and multi-vessel disease?[J].Eur Heart J,2011,32(4):396-403.
[12]Politi L,Sgura F,Rossi R,et al.A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction:major adverse cardiac events during long-term follow-up[J].Heart,2010,96(9):662-667.
[13]Corpus RA,House JA,Marso SP.Multivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction[J].Am Heart J,2005,14 (1):44.
[14]Tonino PA,De Bruyne B,Pijls NH,et al.Fractional flow reserve versus angiography for guiding percutaneous coronary intervention[J].N Engl J Med,2009,360(3):213-224.
[15]Hannan EL,Samadashvili Z,Walford G,et al.Staged versus one-time complete revascularization with percutaneous coronary intervention for multivessel coronary artery disease patients without ST-elevation myocardial infarction[J].Circ Cardiovasc Interv, 2013, 6(1):12-20.
[16]梁思文,陈 晖,赵慧强,等.SAL指引导管使用56例初步经验[J].心脏杂志,2012,24(4):496-497, 513.
备注/Memo
- 备注/Memo:
- 收稿日期：2014-06-17.
通讯作者：陈晖，主任医师，主要从事冠心病研究Email：Chenhui8706@yahoo.com.cn
作者简介：赵慧强，副主任医师，博士Email：dr.zhaohq@gmail.com
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