Comparison of three treatment strategies for patients with triple-vessel coronary disease and left ventricular dysfunction
Comparison of three treatment strategies for patients with triple-vessel coronary disease and left ventricular dysfunction
复制标题
三支冠心病合并左心功能不全患者三种治疗策略的比较
DOI：
10.1111/joic.12497
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发表时间：
2018-06-01
影响因子：
2.1
通讯作者：
Yuan, Jinqing
中科院分区：
文献类型：
--
作者：
Jiang, Lin;Xu, Lianjun;Yuan, Jinqing
目前的指南推荐对多支冠状动脉疾病和左心室功能不全的患者进行冠状动脉旁路移植术（CABG）。然而，在实际实践中，一些患者接受经皮冠状动脉介入治疗（PCI）或单纯药物治疗（MT）。这三种治疗策略在真实的world.MethodsA的长期结果的比较尚不清楚，在一个单一的中心，从2004年至2011年，共有699名连续患者TVD和LV射血分数40%，没有事先PCI或CABG，并完成了中位数6.2年的随访进行了评价。主要终点为全因死亡。次要终点包括心源性死亡，主要不良心血管和脑血管事件（MACCE;复合全因死亡，心肌梗死，重复血运重建，或中风），和复合endpoint.Results142例（20.3%）进行PCI，201（28.8%）进行冠状动脉旁路移植术，而356（50.9%）单独接受MT的个别组成部分。单用MT与最差生存率相关（P
IntroductionCurrent guidelines recommend coronary artery bypass grafting (CABG) for patients with multivessel coronary disease and left ventricular (LV) dysfunction. However, some patients undergo percutaneous coronary intervention (PCI) or solely medical therapy (MT) in actual practice. The comparison of long-term outcomes of these three treatment strategies in real world is unclear.MethodsA total of 699 consecutive patients in a single centre from 2004 to 2011 who had TVD and LV ejection fraction 40%, no prior PCI or CABG and had completed a median 6.2-year follow-up were evaluated. The primary endpoint was all-cause death. The secondary endpoints included cardiac death, major adverse cardiovascular and cerebrovascular events (MACCE; composite of all-cause death, myocardial infarction, repeat revascularization, or stroke), and the individual components of the composite endpoint.ResultsOne hundred forty-two patients (20.3%) underwent PCI, 201 (28.8%) underwent CABG while 356 (50.9%) received MT alone. MT alone was associated with the worst survival (P