Impact of coronary collateralization on long-term clinical outcomes in type 2 diabetic patients after successful recanalization of chronic total occlusion
Impact of coronary collateralization on long-term clinical outcomes in type 2 diabetic patients after successful recanalization of chronic total occlusion
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冠状动脉侧支循环对慢性完全闭塞成功再通后2型糖尿病患者长期临床结局的影响
DOI：
10.1186/s12933-020-01033-4
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发表时间：
2020-02
影响因子：
9.3
通讯作者：
Shen Wei Feng
中科院分区：
文献类型：
--
作者：
Yang Zhen Kun;Shen Ying;Dai Yang;Wang Xiao Qun;Hu Jian;Ding Feng Hua;Zhang Rui Yan;Lu Lin;Shen Wei Feng
背景评估2型糖尿病（T2 DM）患者成功经皮冠状动脉介入治疗（PCI）慢性完全闭塞（CTO）后冠状动脉侧支的预后作用。方法根据Rentrop评分系统对198例2型糖尿病患者和335例因至少一处CTO病变接受PCI的非糖尿病稳定型心绞痛患者的冠状动脉侧支进行分级。左心室射血分数（LVEF）的测定和主要不良心脑事件（MACCE）记录在follow-up.ResultsPoor抵押更常见于T2 DM患者比非糖尿病患者（40%vs 29%，p = 0.008）。在13.5 ± 4.1个月时，复合MACCE发生率（17.3% vs 27.6%，p = 0.034）和重复血运重建（15.2% vs 25.5%，p = 0.026）较低，LVEF增加非糖尿病组侧支循环良好患者的平均血流量（3.10%vs 1.80%，p = 0.024）高于侧支循环不良患者。T2 DM组的相关性相同（分别为35% vs 44%; 30% vs 36%; 2.14% vs 1.65%），侧枝循环不良的糖尿病患者的全因死亡率更高（p = 0.034）。多变量考克斯比例风险分析显示，冠状动脉侧支化是至MACCE时间的独立因素（HR 2.155，95% CI 1.290-3.599，p = 0.003）和重复血运重建（HR 2.326，95%CI 1.357-3.986，p = 0.002），但T2 DM患者未进入模型。在CTO成功再通后，2型糖尿病患者和非糖尿病患者的冠状动脉侧支化状态对长期临床结局和左心室功能的影响似乎在大小上相似。
BackgroundTo assess the prognostic role of coronary collaterals in patients with type 2 diabetes mellitus (T2DM) after successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).MethodsCoronary collateralization was graded according to Rentrop scoring system in 198 type 2 diabetic patients and 335 non-diabetics with stable angina undergoing PCI for at least one CTO lesion. Left ventricular ejection fraction (LVEF) was determined and major adverse cardio-cerebral events (MACCE) were recorded during follow-up.ResultsPoor collateralization was more common in patients with T2DM than in non-diabetics (40% vs 29%, p = 0.008). At 13.5 ± 4.1 months, the rate of composite MACCE (17.3% vs 27.6%, p = 0.034) and repeat revascularization (15.2% vs 25.5%, p = 0.026) was lower and the increase in LVEF (3.10% vs 1.80%, p = 0.024) was greater in patients with good collaterals than in those with poor collaterals for non-diabetic group. The associations were in the same direction for T2DM group (35% vs 44%; 30% vs 36%; 2.14% vs 1.65%, respectively) with a higher all-cause mortality in diabetic patients with poor collaterals (p = 0.034). Multivariable Cox proportional hazards analysis showed that coronary collateralization was an independent factor for time to MACCE (HR 2.155,95% CI 1.290–3.599, p = 0.003) and repeat revascularization (HR 2.326, 95% CI 1.357–3.986, p = 0.002) in non-diabetic patients, but did not enter the model in those with T2DM.ConclusionsT2DM is associated with reduced coronary collateralization. The effects of the status of coronary collateralization on long-term clinical outcomes and left ventricular function appear to be similar in size in type 2 diabetic patients and non-diabetics after successful recanalization of CTO.
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影响因子：
5.3
作者：
通讯作者：
--
影响因子：
9.3
作者：
Shen Y;Ding FH;Dai Y;Wang XQ;Zhang RY;Lu L;Shen WF
通讯作者：
Shen WF
DOI：
--
发表时间：
2014
期刊：
--
影响因子：
--
作者：
Stephan Achenbach;Helmut Baumgartner;J. J. Bax-J.;V. Dean;Christi Deaton;Çetin Erol;R. Fagard
通讯作者：
Stephan Achenbach;Helmut Baumgartner;J. J. Bax-J.;V. Dean;Christi Deaton;Çetin Erol;R. Fagard
影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
6.2
作者：
Neumann, Franz-Josef;Sousa-Uva, Miguel;Zembala, Michael O.
通讯作者：
Zembala, Michael O.