非顺应球囊后扩张对置入药物洗脱支架预后的影响

目的评估使用非顺应性球囊后扩张对经置入药物洗脱支架冠状动脉粥样硬化性心脏病(以下简称冠心病)患者的疗效。方法回顾性分析2011年1月至2011年5月共356例行药物洗脱支架植入且使用非顺应性球囊后扩张的患者,采用倾向性评分抽取同期356例行药物洗脱支架植入术而未后扩张的患者与之1∶1匹配。结果 2组在年龄、性别、临床表现、主要危险因素及冠状动脉病变特征方面比较,差异无统计学意义(P>0.05),具有可比性。平均随访时间18个月,后扩张组主要不良心血管事件(major adverse cardiac events,MACE)明显低于未后扩张组(10.1%vs 15.7%,P=0.020),主要是靶血管重建(6.2%vs10.7%,P=0.010)、支架内血栓(1.1%vs 3.7%,P=0.030)发生率比较,差异有统计学意义(P<0.05),而心肌梗死(3.9%vs4.6%,P=0.700)、死亡(1.1%vs 1.7%,P=0.760)比较,差异没有统计学意义。结论冠心病患者置入药物洗脱支架后使用非顺应性球囊后扩张安全,可改善患者的临床预后。

Clinical outcomes of postdilatation with non-compliant balloons following implantation of drug-eluting stents

Objective To assess the clinical effects of postdilatation with non-compliant balloons following implantation of drug-eluting stents(DES) in patients with coronary artery disease. Methods From January 2011 to July 2011, 356 consecutive patients underwent postdilatation with non-compliant balloons following implantation of DES at Beijing Anzhen Hospital, Capital Medical University. Via propensity score methodology, these patients were matched with 1 group of 356 patients who underwent DES without postdilatation during the same period. Results The two groups were similar for age, sex, clinical presentation, main risk factors and the features of coronary artery lesions. At 18-month follow-up incidence of major adverse cardiac events(MACE) was 10.1% in the postdilatation treatment group and 15.7% in routine un-postdilatation group(P=0.020), with a significant difference in target vessel revascularization and stent thrombosis(6.2% vs 10.7%, P=0.010; and 1.1% vs 3.7%, P=0.030, respectively).There were no statistical differences in myocardial infarction(AMI) and death rates in the two groups(3.9% vs 4.6%, P=0.700; 1.7% vs 1.3%, P=0.229; and 1.1% vs 1.7%, P=0.760, respectively). Conclusion Postdilatation after DES implantation in patients with coronary artery disease is safe and associated improved clinical outcomes.