Multiple arterial coronary bypass grafting is associated with greater survival in women.
Multiple arterial coronary bypass grafting is associated with greater survival in women.
复制标题
多动脉冠状动脉旁路移植术与女性的更高生存率相关。
DOI：
10.1136/heartjnl-2020-317737
复制
发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Fremes SE
中科院分区：
文献类型：
--
作者：
Tam DY;Rocha RV;Fang J;Ouzounian M;Chikwe J;Lawton J;Ko DT;Austin PC;Gaudino M;Fremes SE
在大多数男性的观察性研究中，冠状动脉旁路移植术（CABG）中的多动脉移植术（MAG）与较高的生存率和无主要不良心脑血管事件（MACCE）相关。目前尚不清楚MAG是否对女性有益。我们的目的是比较MAG与单动脉移植（SAG）在接受CABG治疗多支血管疾病的女性中的长期临床结局。链接加拿大安大略的临床和管理数据库，以获得2008-2019年期间接受孤立非紧急初次CABG的左主干、三支或双支血管疾病血管造影证据的所有女性。进行1：1倾向评分匹配。采用分层对数秩检验和Cox比例风险模型比较匹配组之间的晚期死亡率和MACCE（卒中、心肌梗死、重复血运重建和死亡的复合终点）。分别有2，961和7，954名女性因多支血管疾病接受了MAG和SAG CABG。在倾向评分匹配之前，与SAG相比，接受MAG的患者更年轻（66.0 vs. 68.9岁），合并症较少。在倾向评分匹配后，在2,446对匹配良好的配对中，MAG和SAG之间的30天死亡率没有显著差异（1.6% vs 1.8%，P=0.43）。中位和最长随访时间分别为5.0年和11.0年，MAG与更高的生存率（风险比（HR）：0.85，95%置信区间（CI）：0.75-0.98）和无MACCE（HR：0.85，95%CI：0.76-0.95）相关。MAG与更高的生存率和免于MACCE相关，对于需要CABG的预期寿命良好的女性应考虑MAG。
Multiple arterial grafting (MAG) in coronary artery bypass grafting (CABG) is associated with higher survival and freedom from major adverse cardiac and cerebrovascular events (MACCE) in observational studies of mostly men. It is not known whether MAG is beneficial in women. Our objectives were to compare the long-term clinical outcomes of MAG versus single arterial grafting (SAG) in women undergoing CABG for multivessel disease. Clinical and administrative databases for Ontario, Canada, were linked to obtain all women with angiographic evidence of left main, triple, or double vessel disease undergoing isolated non-emergent primary CABG from 2008–2019. 1:1 propensity score matching was performed. Late mortality and MACCE (composite of stroke, myocardial infarction, repeat revascularization, and death) was compared between the matched groups with a stratified log rank test and Cox-proportional hazard model. 2,961 and 7,954 women underwent CABG with MAG and SAG respectively for multivessel disease. Prior to propensity-score matching, compared to SAG, those that underwent MAG were younger (66.0 vs. 68.9 years) and had less comorbidities. After propensity-score matching, in 2,446 well-matched pairs, there was no significant difference in 30-day mortality (1.6% vs 1.8%, P=0.43) between MAG and SAG. Over a median and maximum follow-up of 5.0 and 11.0 years respectively, MAG was associated with greater survival (hazard ratio (HR): 0.85, 95% confidence interval (CI): 0.75–0.98) and freedom from MACCE (HR: 0.85, 95%CI: 0.76–0.95). MAG was associated with greater survival and freedom from MACCE and should be considered for women with good life expectancy requiring CABG.
登录
查看更多内容
影响因子：
4.6
作者：
Jabagi, Habib;Tran, Diem T.;Rubens, Fraser D.
通讯作者：
Rubens, Fraser D.
DOI：
10.1161/circoutcomes.114.001416
发表时间：
2015-03-01
影响因子：
6.9
作者：
Tu, Jack V.;Chu, Anna;Stukel, Therese A.
通讯作者：
Stukel, Therese A.
影响因子：
158.5
作者：
Taggart, David P.;Benedetto, Umberto;Flather, Marcus
通讯作者：
Flather, Marcus
影响因子：
5.4
作者：
Sun, Louise Y.;Tu, Jack, V;Liu, Peter P.
通讯作者：
Liu, Peter P.
影响因子：
4.6
作者：
Lawton, JS;Barner, HB;Damiano, RJ
通讯作者：
Damiano, RJ