左冠状动脉主干疾病的循证管理

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio
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引用次数: 0

摘要

左主干冠状动脉疾病(LMCAD)由于存在巨大的心肌风险,因此发病率和死亡率都很高。虽然药物治疗可能是部分低风险患者的选择,但对于大多数左主干严重狭窄的患者,建议进行血管重建以提高生存率。过去十年间,多项随机临床试验和荟萃分析对冠状动脉旁路移植手术(CABG)和经皮冠状动脉介入治疗(PCI)进行了比较,结果存在争议。LMCAD 血管再通的策略仍然具有挑战性。冠状动脉解剖的复杂性、临床特征和患者的偏好是心脏团队需要考虑的关键因素。目前的指南将 CABG 定义为标准疗法,但 PCI 技术的不断改进、冠状动脉内成像和功能评估的使用,使 PCI 成为选定患者(尤其是合并症患者和有 CABG 禁忌症的患者)的可行替代方案。本综述分析了在 LMCAD 患者中比较 CABG 与 PCI 的最重要研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evidence-based Management of Left Main Coronary Artery Disease
Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.
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来源期刊
European Cardiology Review
European Cardiology Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.40
自引率
0.00%
发文量
23
审稿时长
12 weeks
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