新发病例和支架内再狭窄病例经皮冠状动脉介入治疗后的疗效比较

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology Pub Date : 2024-10-24 DOI:10.1016/j.amjcard.2024.10.019

Lars Jakobsen MD , Evald H. Christiansen MD , Phillip Freeman MD , Johnny Kahlert PhD , Karsten Veien MD , Michael Maeng MD , Julia Ellert MD , Steen D. Kristensen MD , Martin K. Christensen MD , Christian J. Terkelsen MD , Troels Thim MD , Jens Flensted Lassen MD , Mikkel Hougaard MD , Ashkan Eftekhari MD , Rebekka V. Jensen MD , Nicolaj B. Støttrup MD , Jeppe G. Rasmussen MD , Anders Junker MD , Lisette O. Jensen MD

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引用次数: 0

摘要

经皮冠状动脉介入治疗（PCI）后仍会发生支架内再狭窄（ISR）。很少有研究比较PCI术后新生冠状动脉狭窄和ISR的治疗效果，结果也相互矛盾。本研究旨在比较针对 ISR 和新生冠状动脉狭窄进行 PCI 治疗后的疗效。利用随机全样本 SORT OUT 研究 III-X 的患者数据，我们纳入了所有既往接受过 PCI 且以 ISR 或新生病变为研究目标病变的患者。我们关注的结果是主要心脏不良事件（MACE）和5年后靶病变血运重建（TLR）。在SORT OUT研究纳入的2928名既往接受过PCI治疗的患者中，491人（17%）接受了ISR治疗，2437人（83%）接受了新生血管狭窄治疗。基线特征无明显差异。5年后，ISR组有148名患者（32%）发生MACE，新生血管狭窄组有654名患者（28%）发生MACE（粗略和调整后HR分别为1.16（0.97-1.38）和1.16（0.97-1.38））。与新生血管狭窄组相比，ISR 组发生 TLR 的风险更高（粗略和调整 HR 分别为 1.64（95% CI，1.24-2.17）和 1.71（95% CI，1.27-2.30））。总之，对ISR和新生病变进行PCI治疗后，5年后发生MACE的风险相似。然而，ISR组发生TLR的风险高于新生狭窄组。

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Comparison of Outcome After Percutaneous Coronary Intervention for De Novo and In-Stent Restenosis Indications

In-stent restenosis (ISR) still occurs after percutaneous coronary intervention (PCI). Few studies have compared the outcomes of PCI for de novo stenosis with those of PCI for ISR, and the results are conflicting. The present study aimed to conduct this comparison. Using patient-level data from the randomized all-comer SORT OUT studies III to X, we included all patients with previous PCI and either an ISR or a de novo lesion as the study target lesion. Outcomes of interest were major adverse cardiac events (MACE) and target lesion revascularization (TLR) after 5 years. Of the 2,928 patients with a previous PCI included in the SORT OUT studies, 491 (17%) were treated for ISR and 2,437 (83%) for a de novo stenosis. Baseline characteristics did not differ significantly. At 5 years, MACE occurred in 148 patients (32%) in the ISR group and 654 patients (28%) in the de novo stenosis group (crude and adjusted hazard ratio 1.16 [95% confidence interval (CI) 0.97 to 1.38] and 1.16 [95% CI 0.97 to 1.38]). The risk of TLR was higher in the ISR group compared with the de novo stenosis group (crude and adjusted hazard ratio 1.64 [95% CI 1.24 to 2.17] and 1.71 [95% CI 1.27 to 2.30]). In conclusion, the risk of MACE was similar between PCI for ISR and PCI for de novo lesions after 5 years. However, the risk of TLR was higher in the ISR group compared with the de novo stenosis group.

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来源期刊

American Journal of Cardiology 医学-心血管系统

CiteScore

4.00

自引率

3.60%

发文量

698

审稿时长

33 days

期刊介绍： Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.