on behalf of the CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators. Single-session Versus Staged Procedures for Elective Multi-vessel Percutaneous Coronary Intervention.
on behalf of the CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators. Single-session Versus Staged Procedures for Elective Multi-vessel Percutaneous Coronary Intervention.
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代表 CREDO-Kyoto PCI/CABG 登记组第 2 组研究人员。
DOI：
10.1136/heartjnl-2017-312117
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Kimura T,
中科院分区：
文献类型：
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作者：
Toyota T;Morimoto T;Shiomi H;Yamaji K;Ando K;Ono K;Shizuta S;Saito N;Kato T;Kaji S;Furukawa Y;Nakagawa Y;Kadota K;Horie M;Kimura T,
ObjectivesTo阐明单次多支血管经皮冠状动脉介入治疗（PCI）策略相对于分期多支血管策略对稳定型冠状动脉疾病（CAD）或非ST段抬高急性冠状动脉综合征患者临床结局的影响。有2018例患者接受了选择性多支血管PCI。主要结局指标为全因死亡，心肌梗死和中风在5年follow-up.ResultsSingle-session多支血管PCI和分期多支血管PCI进行707例（35.0%）和1311例（65.0%），分别。单次治疗组和分期治疗组的主要结局指标的累积5年发生率和校正风险无显著差异（26.7% vs 23.0%，p=0.45; HR 0.91，95% CI 0.72 - 1.16，p=0.47）。单次治疗组的30天全因死亡发生率显著高于分期治疗组（1.1% vs 0.2%，p=0.009）。但11例30天内死亡的患者死亡原因一般与手术并发症无关，而与PCI前严重的临床状态有关。对于包括年龄、性别、CAD程度、严重慢性肾脏疾病和心力衰竭的亚组分析，亚组因素和单次会话策略相对于分期策略对主要结局measure.ConclusionsThe单次会话multivessel PCI策略与分期multivessel PCI相比至少具有可比的5年临床结局相关，尽管在本研究中单次治疗策略的流行率较低。
ObjectivesTo clarify the effect of single-session multivessel percutaneous coronary intervention (PCI) strategy relative to the staged multivessel strategy on clinical outcomes in patients with stable coronary artery disease (CAD) or non-ST-elevation acute coronary syndrome.MethodsIn the Coronary REvascularisation Demonstrating Outcome Study in Kyoto PCI/coronary artery bypass grafting registry cohort-2, there were 2018 patients who underwent elective multivessel PCI. Primary outcome measure was composite of all-cause death, myocardial infarction and stroke at 5-year follow-up.ResultsSingle-session multivessel PCI and staged multivessel PCI were performed in 707 patients (35.0%) and 1311 patients (65.0%), respectively. The cumulative 5-year incidence of and adjusted risk for the primary outcome measure were not significantly different between the single-session and staged groups (26.7% vs 23.0%, p=0.45; HR 0.91, 95% CI 0.72 to 1.16, p=0.47). The 30-day incidence of all-cause death was significantly higher in the single-session group than in the staged group (1.1% vs 0.2%, p=0.009). However, the causes of death in 11 patients who died within 30 days were generally not related to the procedural complications, but related to the serious clinical status before PCI. For the subgroup analyses including age, gender, extent of CAD, severe chronic kidney disease and heart failure, there was no significant interaction between the subgroup factors and the effect of the single-session strategy relative to the staged strategy for the primary outcome measure.ConclusionsThe single-session multivessel PCI strategy was associated with at least comparable 5-year clinical outcomes compared with the staged multivessel PCI, although the prevalence of the single-session strategy was low in the present study.