首页|不同SYNTAX评分冠心病患者置入不同药物洗脱支架对长期临床结局影响

不同SYNTAX评分冠心病患者置入不同药物洗脱支架对长期临床结局影响

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目的 探讨不同SYNTAX评分的冠心病患者置入生物可降解涂层药物洗脱支架(BP-DES)或永久涂层药物洗脱支架(DP-DES)后对长期临床预后的影响。方法 选取I-LOVE-IT 2 研究中置入BP-DES或DP-DES的 2 737 例患者为研究对象。根据 SYNTAX 评分将患者分为 A 组(SYNTAX 评分<7。0 分，n=774)、B 组(7。0 分≤SYNTAX 评分<13。5 分，n=1 046)、C组(SYNTAX评分≥13。5 分，n=917)。本研究的主要终点事件为4 年靶病变失败(TLF)，包括心源性死亡、靶血管心肌梗死(TVMI)、缺血驱动的靶病变血运重建的复合终点;次要终点为TLF的各个组分及全因死亡。记录并比较 3 组患者的临床资料、介入资料及终点事件发生情况。结果 3 组患者高血压、高脂血症、既往心肌梗死、既往经皮冠状动脉介入治疗比例及肌酐清除率比较，差异均有统计学意义(P<0。05)。3 组患者支架个数、支架总长度、靶血管位置比较，差异均有统计学意义(P<0。05)。3 组患者 TLF、TVMI 发生率比较，差异均有统计学意义(P<0。05)。随着 SYNTAX 评分增加，置入BP-DES与DP-DES患者中TLF、TVMI发生风险均呈上升趋势;随着SYNTAX评分增加，置入BP-DES患者发生TVMI风险持续低于置入DP-DES患者，置入两种支架后发生 TLF 风险无显著差异。结论 随着 SYNTAX 评分增加，置入 BP-DES、DP-DES患者发生TLF、TVMI的风险均升高，而置入BP-DES患者发生TVMI的风险持续低于置入DP-DES患者。
Effect of different drug-eluting stents on long-term clinical outcomes in patients with coronary artery disease based on differ-ent SYNTAX score
Objective To investigate the effect of biodegradable polymer drug-eluting stent(BP-DES)or durable polymer drug-eluting stent(DP-DES)on long-term clinical prognosis in patients with coronary artery disease based on different SYNTAX score.Methods 2 737 patients with BP-DES or DP-DES implanted in the I-LOVE-IT 2 study were selected as the study subjects.According to SYNTAX score,patients were divided into group A(SYNTAX score<7.0,n=774),group B(7.0≤SYNTAX score<13.5,n=1 046),and group C(SYNTAX score≥13.5,n=917).The primary endpoint event of this study was 4-year target lesion failure(TLF),which included the combined endpoint of cardiac death,target vessels myocardial infarction(TVMI),and ischemia-driven tar-get lesion revascularization.The secondary endpoints were all components of TLF and all-cause death.The clinical data,interventional data and endpoint events of the 3 groups were recorded and compared.Results There were significant differences in the proportion of hypertension,hyperlipidemia,previous myocardial infarction,previous percutaneous coronary intervention and creatinine clearance a-mong 3 groups(P<0.05).There were statistically significant differences in the number of stents,total length of stents and location of target vessels among 3 groups(P<0.05).There were significant differences in the incidence of TLF and TVMI among 3 groups(P<0.05).With the increase of SYNTAX score,the risk of TLF and TVMI in BP-DES and DP-DES patients increased.With the increase of SYNTAX score,the risk of TVMI in patients with BP-DES implantation was continuously lower than that in patients with DP-DES implantation,and there was no significant difference in the risk of TLF after implantation of the two stents.Conclusion With the in-crease of SYNTAX score,the risk of TLF and TVMI in patients with BP-DES and DP-DES increases,while the risk of TVMI in patients with BP-DES is continuously lower than that in patients with DP-DES.

Coronary artery diseasePercutaneous coronary interventionSYNTAX scoreBiodegradable polymer drug-eluting stentDurable polymer drug-eluting stent

段一璇、刘道申、周尚珣、徐颖、母雪飞、祁子钊、李晶、李毅、韩雅玲、裘淼涵

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北部战区总医院 心血管内科,辽宁 沈阳 110016

空军军医大学,陕西 西安 710032

冠心病 经皮冠状动脉介入治疗 SYNTAX评分 生物可降解涂层药物洗脱支架 永久涂层药物洗脱支架

国家重点研发计划国家重点研发计划

2022YFC25035002022YFC2503504

2024

10.16680/j.1671-3826.2024.06.03

临床军医杂志
解放军沈阳军区卫生人员训练基地

临床军医杂志

CSTPCD
影响因子：0.465
ISSN：1671-3826
年,卷(期)：2024.52(6)
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