CORONARY REVASCULARIZATION IN INSULIN-DEPENDENT DIABETIC-PATIENTS WITH CHRONIC-RENAL-FAILURE
CORONARY REVASCULARIZATION IN INSULIN-DEPENDENT DIABETIC-PATIENTS WITH CHRONIC-RENAL-FAILURE
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DOI：
10.1016/0140-6736(92)93010-k
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发表时间：
1992-10-24
期刊：
影响因子：
168.9
通讯作者：
WHITE, CW
中科院分区：
文献类型：
--
作者：
MANSKE, CL;WANG, Y;WHITE, CW
胰岛素依赖型糖尿病患者在评估肾移植时发现有严重的冠状动脉疾病，2年生存率低于50%。由于大多数此类患者没有心绞痛症状，因此其管理存在争议。我们试图找出是否冠状动脉血运重建在这样的患者可能会降低不稳定型心绞痛，心肌梗死和心脏性死亡的综合发病率。151个连续的胰岛素依赖型糖尿病肾移植候选人进行冠状动脉造影。31例有一条或多条冠状动脉狭窄大于75%，非典型胸痛或无胸痛，左心室射血分数大于0.35。其中，26人同意接受随机分配的药物治疗（钙通道阻滞剂加阿司匹林）或血管重建（血管成形术或冠状动脉搭桥手术）。13例药物治疗的患者中有10例和13例血运重建的患者中有2例在中位8.4个月的冠状动脉造影内发生心血管终点（p
Insulin-dependent diabetic patients found to have substantial coronary artery disease at the time of assessment for renal transplantation have 2-year survival of less than 50%. Because most of these patients have no angina symptoms their management is controversial. We tried to find out whether coronary artery revascularisation in such patients might decrease the combined incidence of unstable angina, myocardial infarction, and cardiac death.151 consecutive insulin-dependent diabetic candidates for renal transplantation underwent coronary angiography. 31 had stenoses greater than 75% in one or more coronary arteries, atypical chest pain or no chest pain, and a left ventricular ejection fraction greater than 0.35. Of these, 26 agreed to be randomly assigned medical treatment (a calcium-channel-blocking drug plus aspirin) or revascularisation (angioplasty or coronary bypass surgery). 10 of 13 medically managed and 2 of 13 revascularised patients had a cardiovascular endpoint within a median of 8.4 months of coronary angiography (p