Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions
Predictors and Outcomes of Ad Hoc Versus Non-Ad Hoc Percutaneous Coronary Interventions
复制标题
DOI：
10.1016/j.jcin.2009.01.006
复制
发表时间：
2009-04-01
影响因子：
11.3
通讯作者：
King, Spencer B., III
中科院分区：
文献类型：
--
作者：
Hannan, Edward L.;Samadashvili, Zaza;King, Spencer B., III
目的：我们的目的是比较长期的结果为特设经皮冠状动脉介入治疗（PCI）和非特设PCI.Background特设PCI，即PCI后立即进行心导管插入术，已成为最常见的方式进行PCI。然而，没有研究比较了临时和非临时PCI的长期结果。方法2003年1月1日至2005年6月30日期间，在非联邦纽约州医院接受PCI的纽约州患者共46，565例，随访至2005年12月31日，比较了临时和非临时PCI的住院和长期结果。结果经风险调整后的住院死亡率无差异（调整后的ad hoc/non-ad hoc比值比：0.82，95%可信区间[CI]：0.55 ~ 1.22）。临时PCI患者的36个月死亡率显著较低（校正的风险比[HR]：0.76，95% CI：0.69至0.85，p < 0.0001）。临时PCI患者的36个月后续血运重建显著高于（调整后HR：1.11，95% CI：1.01 - 1.21，p = 0.03），但排除另一条血管首次PCI后30天内发生的后续PC后，差异不再显著（调整后HR：1.03，95%CI：0.95 - 1.12，p = 0.43）结论：平均而言，低风险患者接受临时PCI，在对患者组合差异进行风险调整后，临时PCI患者的3年死亡率较低。（美国科尔心脏病学杂志2009;2：350-6）（C）2009年美国心脏病学会基金会
Objectives Our aim was to compare longer-term outcomes for ad hoc percutaneous coronary intervention (PCI) and non-ad hoc PCI.Background Ad hoc PCIs, whereby PCI is performed immediately after cardiac catheterization, has become the most common way of performing PCI. However, no studies have compared longer-term outcomes for ad hoc and non-ad hoc PCIs.Methods A total of 46,565 New York State patients who underwent PCI in nonfederal New York State hospitals between January 1, 2003 and June 30, 2005 were followed through December 31, 2005, and in-hospital and longer-term outcomes were compared for ad hoc and non,ad hoc PCI patients after adjusting for differences in pre-procedural risk factors.Results There was no difference in risk-adjusted in-hospital mortality (adjusted ad hoc/non-ad hoc odds ratio: 0.82, 95% confidence interval [Cl]: 0.55 to 1.22). Ad hoc PCI patients had significantly lower 36-month mortality (adjusted hazard ratio [HR]: 0.76, 95% CI: 0.69 to 0.85, p < 0.0001). Ad hoc PCI patients had significantly higher 36-month subsequent revascularization (adjusted HR: 1.11, 95% CI: 1.01 to 1.21, p = 0.03), but after excluding subsequent PC's that occurred within 30 days of the index PCI in another vessel, the difference was no longer significant (adjusted HR: 1.03, 95% CI: 0.95 to 1.12, p = 0.43).Conclusions On average, lower-risk patients undergo ad hoc PCI, and after risk-adjustment for differences in patient mix, ad hoc PCI patients have lower 3-year mortality rates. (J Am Coll Cardiol Intv 2009;2:350-6) (C) 2009 by the American College of Cardiology Foundation