Has improvement in PTCA intervention affected long-term prognosis? The NHLBI PTCA Registry experience.
Has improvement in PTCA intervention affected long-term prognosis? The NHLBI PTCA Registry experience.
复制标题
PTCA 干预的改善是否影响长期预后？
DOI：
10.1161/01.cir.91.12.2868
复制
发表时间：
1995
期刊：
影响因子：
37.8
通讯作者：
Kent,K
中科院分区：
文献类型：
--
作者：
Detre,K;Yeh,W;Kelsey,S;Williams,D;Desvigne-Nickens,P;HolmesJr,D;Bourassa,M;King3rd,S;Faxon,D;Kent,K
背景NHLBI 经皮冠状动脉腔内成形术 (PTCA) 登记处对 1977 年至 1981 年间连续 1345 名首次接受 PTCA 的患者（登记处 1）和 1985 年至 1986 年间连续接受 PTCA 的 2136 名患者（登记处 2）进行了随访。介绍了患者选择以及近期和一年结果的变化。本报告将早期和近期 PTCA 治疗效果的比较延伸至 5 年。 方法和结果 16 个参与中心连续纳入 1977 年至 1981 年和 1985 年至 1986 年期间首次接受血管成形术的患者。近期发生心肌梗死 (MI) 的患者被排除在外。血管疾病是根据冠状动脉手术研究定义的。成功的扩张需要干预后管腔狭窄减少≥20%且管腔直径狭窄<50%。通过电话访谈进行例行年度随访。使用乘积限制方法来估计不良事件的发生率，使用 Cox 回归分析来模拟两个登记处之间事件的相对风险和调整后的相对风险，并在结果的确切时间（例如症状复发）未知时使用逻辑回归。根据所有患者和最初成功接受 PTCA 的患者队列的血管疾病计算长期事件率。在对疾病程度、糖尿病、既往搭桥手术 (CABG)、高血压、年龄和性别进行调整后，两个登记队列的 5 年死亡风险相似。然而，在注册 2 队列中，所有患者和最初治疗成功的患者的 MI、CABG 发生率以及死亡、MI 和/或 CABG 的综合结果指标均显着较低。后一队列中重复 PTCA 的使用率较高，并且无不良事件的症状明显更好。结论与注册 1 相比，注册 2 队列的管理导致 5 年病态事件率较低，并减少了 CABG 手术。死亡率保持相似。当将症状状态与事件结合起来考虑时，总体上以及最初成功的队列中都看到了明显更好的结果。在登记处 2 中，初次手术后早期重复 PTCA 的使用频率要高得多。
BackgroundThe NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry followed 1345 consecutive patients with first PTCA between 1977 and 1981 (registry 1) and 2136 consecutive patients with PTCA between 1985 and 1986 (registry 2). Changes in patient selection and in immediate and 1-year outcome are presented. This report extends to 5 years the comparison of the effects of early and more recent management with PTCA.Methods and ResultsSixteen participating centers entered consecutive patients who had angioplasty for the first time between 1977 and 1981 and between 1985 and 1986. Patients with recent myocardial infarction (MI) were excluded. Vessel disease was defined according to the Coronary Artery Surgery Study. Successful dilatation required ≥20% reduction in luminal narrowing and <50% lumen diameter stenosis after intervention. Routine annual follow-up was conducted by telephone interview. The product-limit method was used to estimate freedom from untoward events, Cox regression analysis to model relative risk and adjusted relative risk of events between the two registries, and logistic regression when the exact time of outcome (such as recurrence of symptoms) was not known. Long-term event rates were computed by vessel disease for all patients and for the cohort of patients with initially successful PTCA. After adjustment for extent of disease, diabetes, prior bypass surgery (CABG), hypertension, age, and sex, the 5-year risk of death was similar in the two registry cohorts. However, rates of MI, CABG, and a combined outcome measure of death, MI, and/or CABG were significantly lower in the registry 2 cohort both for all patients and for patients who were initially treated successfully. Use of repeated PTCA was higher, and freedom from symptoms without adverse events was significantly better in the latter cohort.ConclusionsCompared with registry 1, the management of the registry 2 cohort resulted in lower 5-year morbid event rates and reduced CABG operations. Mortality rates remained similar. When symptomatic status was considered in combination with events, a significantly better outcome was seen overall and in the initially successful cohort. In registry 2, repeated PTCA was used with much greater frequency early after the initial procedure.
登录
查看更多内容
427 名患者尝试经皮腔内冠状动脉成形术 5 年后的临床结果。
影响因子：
37.8
作者：
J D Talley;J. W. Hurst;S. B. King;J. S. Douglas;G. Roubin;A. Gruentzig;H. Anderson;W. S. Weintraub
通讯作者：
W. S. Weintraub
冠状动脉血管成形术——长期随访结果和再狭窄检测：航空心脏病学指南。
影响因子：
39.3
作者：
P. Serruys;A. Breeman
通讯作者：
A. Breeman
影响因子：
1.3
作者：
H. Blackburn
通讯作者：
H. Blackburn
ISFC/WHO 冠状动脉成形术联合工作组的报告。
影响因子：
37.8
作者：
M. Bourassa;Edwin L. Alderman;Michel Bertrand;Luis de la Fuente;A. Gratsianski;Martin Kaltenbach;Spencer B. King;Masakiyo Nobuyoshi;P. Romaniuk;Thomas J. Ryan;P. Serruys;Hugh C. Smith;J. Sousa;S. Bothig;Elliot Rapaport
通讯作者：
Elliot Rapaport
DOI：
--
发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox