Real-World Outcomes of Revascularization Strategies in Patients With Left Ventricular Dysfunction and Three-Vessel Coronary Disease Stratified by Mitral Regurgitation.
Real-World Outcomes of Revascularization Strategies in Patients With Left Ventricular Dysfunction and Three-Vessel Coronary Disease Stratified by Mitral Regurgitation.
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DOI：
10.3389/fcvm.2021.675722
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发表时间：
2021
影响因子：
3.6
通讯作者：
Tao R
中科院分区：
文献类型：
--
作者：
Fan Q;Liu J;Xu Y;Ni R;Xi R;Wang F;Hu J;Sun H;Yang Z;Zhou M;Zhang R;Zhao Q;Tao R
目的：关于三支冠状动脉疾病（TVD）、心力衰竭（HF）和不同程度的二尖瓣反流（MR）患者的最佳血运重建方案的信息有限。因此，我们的目的是比较经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）手术在指定患者中的效果。方法和结果：在现实世界的前瞻性研究中，入组了 1190 名患有多支血管病变、左心室收缩功能下降但无严重 MR 且接受 PCI 或 CABG 的患者，并随访 4.7 ± 1.8 年。主要终点是心血管死亡和心力衰竭住院的复合终点。次要终点是主要终点的各个组成部分。 PCI组的主要终点风险高于CABG组（HR=1.38，95%CI：1.14-1.67，P<0.01），特别是中度MR患者（HR=1.85，95%CI：1.35-2.55，P<0.01）。在非轻度 MR 患者中，PCI 和 CABG 之间主要终点的风险没有显着差异 (P = 0.09)。在中度 MR 队列中，PCI 治疗与心血管死亡和心衰住院风险增加相关，而在非轻度 MR 队列中，PCI 与 CABG 相当。结论：在这项真实世界研究中，对于 HF 和 TVD 患者，与 PCI 相比，CABG 的不良结果发生率较低。 MR 评估有助于选择最佳的血运重建疗法和风险分层。
Aims: Limited information exists regarding optimal revascularization options for patients with triple-vessel coronary artery disease (TVD), heart failure (HF), and different degrees of mitral regurgitation (MR). Thus, we aimed to compare the effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) surgery in the indicated patients. Methods and Results: In the real-world prospective study, 1190 patients with multi-vessel disease and decreased left ventricular systolic function but without severe MR, who underwent PCI or CABG, were enrolled and followed-up for 4.7 ± 1.8 years. The primary endpoint was a composite of cardiovascular death and HF hospitalization. Secondary endpoints were the individual components of the primary outcome. Risk of the primary endpoint was higher in the PCI than in the CABG group (HR = 1.38, 95%CI: 1.14–1.67, and P < 0.01), particularly in patients with moderate MR (HR = 1.85, 95%CI: 1.35–2.55, and P < 0.01). In patients with no-mild MR, the risk of the primary endpoint did not differ significantly between PCI and CABG (P = 0.09). Treatment with PCI was associated with an increased risk for cardiovascular death and HF hospitalization in the moderate MR cohort, while PCI was comparable to CABG in the no-mild MR cohort. Conclusions: In this real-world study, for patients with HF and TVD, CABG was related to lower adverse outcome rates compared to PCI. Assessment of MR can aid in selecting optimal revascularization therapies and in risk stratification.
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影响因子：
39.3
作者：
Ronco C;McCullough P;Anker SD;Anand I;Aspromonte N;Bagshaw SM;Bellomo R;Berl T;Bobek I;Cruz DN;Daliento L;Davenport A;Haapio M;Hillege H;House AA;Katz N;Maisel A;Mankad S;Zanco P;Mebazaa A;Palazzuoli A;Ronco F;Shaw A;Sheinfeld G;Soni S;Vescovo G;Zamperetti N;Ponikowski P;Acute Dialysis Quality Initiative (ADQI) consensus group
通讯作者：
Acute Dialysis Quality Initiative (ADQI) consensus group
影响因子：
120.7
作者：
Abdallah, Mouin S.;Wang, Kaijun;Magnuson, Elizabeth A.;Spertus, John A.;Farkouh, Michael E.;Fuster, Valentin;Cohen, David J.
通讯作者：
Cohen, David J.
DOI：
10.1056/nejmoa1110717
发表时间：
2012-04-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Weintraub WS;Grau-Sepulveda MV;Weiss JM;O'Brien SM;Peterson ED;Kolm P;Zhang Z;Klein LW;Shaw RE;McKay C;Ritzenthaler LL;Popma JJ;Messenger JC;Shahian DM;Grover FL;Mayer JE;Shewan CM;Garratt KN;Moussa ID;Dangas GD;Edwards FH
通讯作者：
Edwards FH
影响因子：
24
作者：
Kamalesh, Masoor;Sharp, Thomas G.;Reda, Domenic
通讯作者：
Reda, Domenic
影响因子：
3.5
作者：
Buja, Paolo;Tarantini, Giuseppe;Iliceto, Sabino
通讯作者：
Iliceto, Sabino