Propensity score-matched analysis of coronary artery bypass grafting versus second-generation drug-eluting stents for triple-vessel disease.
Propensity score-matched analysis of coronary artery bypass grafting versus second-generation drug-eluting stents for triple-vessel disease.
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冠状动脉旁路移植术与第二代药物洗脱支架治疗三支血管疾病的倾向评分匹配分析。
DOI：
10.1093/ejcts/ezy415
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Takanashi S.
中科院分区：
文献类型：
--
作者：
Nishigawa K;Fukui T;Hagiya K;Tobaru T;Uemura K;Takanashi S.
目的比较冠状动脉旁路移植术(CABG)和第二代药物洗脱支架(DESS)治疗三支病变的中期疗效。方法2010年2月至2015年12月，607例患者接受了单纯冠状动脉搭桥术(CABG)，264例患者接受了第二代药物洗脱支架(DESS)治疗三支病变伴或不伴左主干病变。我们使用倾向分数匹配分析对CABG组和第二代DES组进行比较。研究终点为主要不良心脑血管事件。结果倾向性评分匹配后，238对患者配对成功(C统计0.762)。CABG组远端吻合口平均4.7个，第二代DES组平均2.8个。两组的30d死亡率相似(0.8%vs0.4%；P= 0.564)。中位随访期：冠脉搭桥组为3.4 年，第二代DES组为3.8 年。两组的全因死亡和脑血管意外发生率无显著差异，但心肌梗死[危险比(HR)11.76；95%可信区间(CI)2.32~214.15，P= 0.003]和重复血管重建术(HR 3.78；95%CI 2.35~6.38；P<； 0.001)的发生率明显高于冠状动脉旁路移植组。主要不良心脑血管事件发生率较高(HR 2.27；95%CI 1.61~3.24；P<； 0.001)。结论SCABG治疗三支病变的主要不良心脑血管事件明显优于经皮冠状动脉介入治疗。
OBJECTIVESThis study aimed to compare the mid-term results of coronary artery bypass grafting (CABG) with those of percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DESs) for triple-vessel disease.METHODSBetween February 2010 and December 2015, 607 patients underwent primary isolated CABG and 264 patients underwent PCI with second-generation DESs (everolimus-eluting stent, biolimus-eluting stent or zotarolimus-eluting stent) for triple-vessel disease with or without left main disease. We compared the CABG group with the second-generation DES group using propensity score matching analysis. The study end points were major adverse cardiac and cerebrovascular events.RESULTSAfter propensity score matching, 238 pairs of patients were successfully matched (C-statistic 0.762). The mean number of distal anastomoses in the CABG group was 4.7 and that of implanted stents in the second-generation DES group was 2.8. The 30-day mortality was similar between the groups (0.8% vs 0.4%;P= 0.564). The median follow-up period was 3.4 years in the CABG group and 3.8 years in the second-generation DES group. Although there was no significant difference in the incidence of all-cause death and cerebrovascular accidents, the incidence of myocardial infarction [hazard ratio (HR) 11.76; 95% confidence interval (CI) 2.32–214.15,P= 0.003] and repeat revascularization (HR 3.78; 95% CI 2.35–6.38;P< 0.001) was significantly higher in the second-generation DES group than in the CABG group. This resulted in a higher incidence of major adverse cardiac and cerebrovascular events (HR 2.27; 95% CI 1.61–3.24;P< 0.001).CONCLUSIONSCABG might be superior to PCI with second-generation DESs for treatment of triple-vessel disease in terms of major adverse cardiac and cerebrovascular events.
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影响因子：
4.6
作者：
Kinoshita, Takeshi;Asai, Tohru;Matsubayashi, Keiji
通讯作者：
Matsubayashi, Keiji
影响因子：
4.6
作者：
Tatoulis, James;Buxton, Brian F.;Fuller, John A.
通讯作者：
Fuller, John A.
DOI：
10.1016/j.jtcvs.2015.04.058
发表时间：
2015-08-01
影响因子：
6
作者：
Kinoshita, Takeshi;Asai, Tohru;Suzuki, Tomoaki
通讯作者：
Suzuki, Tomoaki
影响因子：
158.5
作者：
Serruys, Patrick W.;Morice, Marie-Claude;Mohr, Friedrich W.
通讯作者：
Mohr, Friedrich W.
接受冠状动脉旁路移植术的患者的移植物选择和一年通畅率。
影响因子：
4.6
作者：
T. Fukui;M. Tabata;S. Manabe;T. Shimokawa;S. Takanashi
通讯作者：
S. Takanashi