冠脉病变支数对冠脉介入治疗术后1年主要心脑血管事件影响

目的探讨冠脉病变支数对冠脉介入治疗术后1年主要心脑血管事件(MACCE)的影响。方法选取2012年1月至2013年3月连续就诊于沈阳军区总医院心血管内科经皮冠状动脉介入治疗的冠心病患者5 702例,其中,单支病变患者1 731例,多支病变患者3 971例,利用倾向性评分匹配对比研究方法,找出与单支病变最匹配的1 731例多支病变患者进行对比研究。采取电话、再住院及信访调查,观察患者的临床特点、生化指标、介入手术资料对MACCE发生的影响。主要终点为介入治疗术后1年MACCE发生情况,包括全因死亡、再次心肌梗死、靶病变/靶血管再次血运重建、脑血管意外。结果两组患者全因死亡、非致死性心肌梗死、缺血性卒中、再次血运重建发生率比较,差异均无统计学意义(P>0.05)。多支病变组心源性死亡发生21例,占1.2%,单支病变组心源性死亡发生10例,占0.6%,两组间比较,差异有统计学意义(P<0.05)。结论冠脉病变支数与冠脉介入治疗术后1年MACCE有关,多支血管病变患者心源性死亡率高。

To evaluate whether the number of vessels disease has an impact on incidence of one year MACCE in patients undergoing percutaneous coronary intervention

Objective To investigate whether the number of vessels disease has an impact on incidence of one year MACCE in pa-tients undergoing percutaneous coronary intervention( PCI) . Methods A retrospective study was performed on 5 702 patients who un-derwent PCI in The General Hospital of Shenyang Military Command from January 2012 to March 2013. Patients were divided in the single vessel disease group(n=1 731) and the multivessel disease group(n=3 971). Using propensity score matching method,to find out the best match with the 1 731 cases of multivessel disease to carry out comparative study. All patients were fllowed up by tele-phone,rehospitalization and mail. Analysis was done in clinical characteristics,examination results,operation information and their in-fluence on incidence of MACCE. The maior end point was MACCE( including all caused death re-myocardial infarction,target vessel revascularization/target lesion revascularization). Results The baseline characteristics were similar among groups,all caused death re-myocardial infarction,target vessel revascularization/target lesion revascularization of two groups showed no difference(P>0. 05). There were 21 cases of cardiac death in the multivessel disease group(1. 2%) and 10 cases(0. 6%) in the single vessel group. There was singificant difference between the two groups(P<0. 05). Conclusion The number of vessels disease is assocoated with one year MACCE after PCI. The cardiac death rate is high in the patients of multivessel disease.