摘要
目的:探讨紫杉醇药物涂层球囊(DCB)对新发冠心病患者经皮冠状动脉介入治疗(PCI)的远期预后影响。方法:以2013年12月至2015年12月,于中国人民解放军联勤保障部队第九○九医院和福建医科大学附属漳州市医院接受紫杉醇(DCB组)和非紫杉醇2代药物洗脱支架(DES)组,PCI治疗的稳定型新发冠心病患者为研究对象。收集并对比两组患者一般临床资料和冠状动脉病变特征。对所有患者进行5年的随访,绘制Kaplan-Meier曲线对比两组患者主要心血管不良事件(MACE)发生率。通过单因素、多因素Cox风险比例回归分析探究预后不良的危险因素。结果:研究纳入了1317例患者,其中DCB组329例,DES组988例。两组患者5年MACE发生率差异无统计学意义(P=0.093)。通过单因素、多因素Cox风险比例回归分析,最终确定患者年龄(HR=1.09,95%CI:1.01~1.18)和吸烟(HR=1.94,95%CI:1.19~3.17)是PCI术后长期预后不良的预测因素。结论:与非紫杉醇2代DES相比,紫杉醇DCB PCI治疗没有增加稳定型新发冠心病患者5年MACE发生率,是新发冠心病患者PCI治疗的安全选择。
Objective:To investigate the long-term prognosis of percutaneous coronary intervention(PCI)with drug-coated balloons(DCB)in de novo coronary heart disease patients.Methods:Stable de novo coronary heart disease(CHD)patients who received paclitaxel DCB or non-paclitaxel second generation drug eluting stent PCI from December 2013 to December 2015 in our hospital were selected as the research objects and divided into DCB group and drug eluted stent(DES)group.The general clinical data and coronary lesion characteristics of all patients were collected and compared between two groups.All patients were followed up for 5 years,and Kaplan Meier curve was drawn to compare the incidence of major adverse cardiovascular events(MACE)between the two groups.Univariate and multivariate Cox regression analysis was used to explore the risk factors of poor prognosis.Results:A total of 1317 patients were included in the study,including 329 in DCB group and 988 in DES group.There was no significant difference in 5-year mace incidence between the two groups(P=0.093).Univariate and multivariate Cox regression analysis showed that age(HR=1.09,95%CI:1.01-1.18)and smoking(HR=1.94,95%CI:1.19-3.17)were predictors of poor long-term prognosis after PCI.Conclusions:Compared with non-paclitaxel generation 2 DES,PCI with paclitaxel DCB does not increase the 5-year MACE incidence in patients with stable de novo coronary heart disease.
作者
黄文莉
蔡少娜
陈晓晴
戴增欢
胡彦
林春艺
吴轲
HUANG Wenli;CAI Shaona;CHEN Xiaoqing;DAI Zenghuan;HU Yan;LIN Chunyi;WU Ke(Department of Cardiology,No.909 Hospital,Joint Logistics Support Force of People’s Liberation Army,Zhangzhou 363000,China)
出处
《心肺血管病杂志》
CAS
2021年第12期1183-1189,共7页
Journal of Cardiovascular and Pulmonary Diseases
基金
福建省医学创新课题项目(2018-CX-42)。
关键词
药物涂层球囊
稳定型冠心病
冠状动脉介入治疗
药物洗脱支架
Drug coated balloon
Stable coronary artery disease
Percutaneous coronary intervention
Drug eluting stent
作者简介
通信作者:吴轲,副主任医师,研究方向:冠心病介入手术。E-mail:doctor_icefrost@163.com。
