Percutaneous transluminal coronary angioplasty in 1985-1986 and 1977-1981. The National Heart, Lung, and Blood Institute Registry.
Percutaneous transluminal coronary angioplasty in 1985-1986 and 1977-1981. The National Heart, Lung, and Blood Institute Registry.
复制标题
1985-1986年和1977-1981年进行经皮腔内冠状动脉成形术。
DOI：
10.1056/nejm198802043180501
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Bourassa,M
中科院分区：
文献类型：
--
作者：
Detre,K;Holubkov,R;Kelsey,S;Cowley,M;Kent,K;Williams,D;Myler,R;Faxon,D;HolmesJr,D;Bourassa,M
1985年8月，国家心肺血液研究所的经皮腔内冠状动脉成形术登记处在其以前的地点重新开放，以记录血管成形术策略和结果的变化。这项新的登记研究纳入了1802名在血管成形术前10天内没有发生心肌梗死的连续患者。将患者选择、技术结果和短期主要并发症与1977年至1981年登记队列进行比较。新登记的患者年龄较大，多支血管疾病的比例明显较高（53%对25%，P<0.001），左心室功能差（19%对8%，P<0.001），既往心肌梗死（37%对21%，P<0.001），既往冠状动脉搭桥手术（13%对9%，P<0.01）。新登记队列的冠状动脉病变也更复杂，这些患者的血管成形术尝试涉及更多的多支血管手术，尽管有这些差异，新队列的住院结局更好。根据病变的血管造影成功率从67%增加到88%（P<0.001），总体成功率（测量为所有病变至少减少20%，无死亡，心肌梗死或冠状动脉搭桥手术）从61%增加到78%（P<0.001）。新队列的住院死亡率为1%，非致命性心肌梗死率为4.3%。这两个比率与旧登记册的比率相似。目前血管成形术的长期疗效仍有待确定。（N Engl J Med 1988; 318：265-70.）
In August 1985, the Percutaneous Transluminal Coronary Angioplasty Registry of the National Heart, Lung, and Blood Institute reopened at its previous sites to document changes in angioplasty strategy and outcome. The new registry entered 1802 consecutive patients who had not had a myocardial infarction in the 10 days before angioplasty. Patient selection, technical outcome, and short-term major complications were compared with those of the 1977 to 1981 registry cohort.The new-registry patients were older and had a significantly higher proportion of multivessel disease (53 vs. 25 percent, P<0.001), poor left ventricular function (19 vs. 8 percent, P<0.001), previous myocardial infarction (37 vs. 21 percent, P<0.001), and previous coronary bypass surgery (13 vs. 9 percent, P<0.01). The new-registry cohort also had more complex coronary lesions, and angioplasty attempts in these patients involved more multivessel procedures.Despite these differences, the in-hospital outcome in the new cohort was better. Angiographic success rates according to lesion increased from 67 to 88 percent (P<0.001), and overall success rates (measured as a reduction of at least 20 percent in all lesions attempted, without death, myocardial infarction, or coronary bypass surgery) increased from 61 to 78 percent (P<0.001). In-hospital mortality for the new cohort was 1 percent, and the nonfatal myocardial infarction rate was 4.3 percent. Both rates are similar to those for the old registry. The long-term efficacy of current angioplasty remains to be determined. (N Engl J Med 1988; 318:265–70.)