支架或药球治疗糖尿病合并支架内再狭窄预后分析
Long-term performance of drug-coated balloons and drug-eluting stents in diabetic patients with in-stent restenosis
李东东 1朱彬 1杨旺伟 1付国涛 1高超 1陶凌1
作者信息
- 1. 空军军医大学第一附属医院心脏内科,陕西西安 710032
- 折叠
摘要
目的 研究糖尿病合并支架内再狭窄(in-stent restenosis,ISR)患者单纯使用药物洗脱支架(DES)或药物涂层球囊(DCB)进行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗,探讨两种器械与患者预后关系.方法 前瞻性纳入 2015年 6月 1日～2020年 6月 1日在空军军医大学第一附属医院行PCI并接受DES或DCB治疗的糖尿病合并支架内再狭窄患者,共 700例.其中,DES治疗患者 380例,DCB治疗患者 320例.主要终点为器械相关复合终点(Device-oriented composite endpoints,DoCE),包括心源性死亡、靶血管心肌梗死和靶血管血运重建.结果 随访 36个月,DoCE发生率支架组 8.7%低于药球组 18.8%,差异具有统计学意义(P<0.05).PoCE发生率支架组 12.9%低于药球组 25.0%,差异具有统计学意义(P<0.05).结论 糖尿病合并支架内再狭窄患者使用DCB的DoCE和PoCE均高于使用药物洗脱支架患者.
Abstract
AIM To investigate the relationship between two different treatment approaches,drug-eluting stents(DES)and drug-coated balloons(DCB),and the clinical prognosis of patients with diabetes mellitus(DM)complicated by in-stent restenosis(ISR).METHODS A total of 700 patients diagnosed with DM and ISR who underwent PCI at Xijing Hospital between June 1,2015,and June 1,2020 were enrolled.Among them,380 patients(54.3%)underwent DES-only treatment,while 320 patients(45.7%)received DCB-only treatment.The primary endpoint was device-oriented composite endpoint(DoCE),defined as a composite endpoint of cardiovascular death,non-fatal target vessel MI(TV-MI),and target lesion revascularization(TLR).RESULTS At 36 months follow-up,the cumulative incidence of the primary endpoint(DoCE)in the DES group(8.7%)was significantly lower than DCB group(18.8%)(P<0.05).Similarly,the cumulative incidence of the secondary endpoint(PoCE)in the DES group(12.9%)was significantly lower than DCB group(25.0%)(P<0.05).CONCLUSION The rates of both DoCE and PoCE are higher in patients with DM and ISR who were treated with DCB compared to DES.
关键词
药物涂层球囊/药物洗脱支架/糖尿病/支架内再狭窄/心血管疾病Key words
drug-coated balloons/drug-eluting stents/diabetes mellitus/in-stent restenosis/cardiovascular disease引用本文复制引用
出版年
2024
NETL
NSTL
万方数据