冠状动脉内β射线放射治疗后的长期预后
Long term outcome after intracoronary beta radiation therapy.
作者信息
Sianos G, Hoye A, Saia F, van der Giessen W, Lemos P, de Feyter P J, Levendag P C, van Domburg R, Serruys P W
机构信息
Department of Interventional Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands.
出版信息
Heart. 2005 Jul;91(7):942-7. doi: 10.1136/hrt.2004.038026.
OBJECTIVES
To determine the long term outcome after intracoronary beta radiation therapy (IRT).
SETTING
Tertiary referral centre.
METHODS
The rate of major adverse cardiac events (MACE) was retrospectively determined in 301 consecutive patients who were treated with IRT. MACE was defined as death, myocardial infarction, or any reintervention. Long term clinical outcome was obtained from an electronic database of hospital records and from questionnaires to the patients and referring physicians. Long term survival status was assessed by written inquiries to the municipal civil registries.
RESULTS
The mean (SD) follow up was 3.6 (1.2) years. The cumulative incidence of MACE at six months was 19.1%, at one year 36.4%, and at four years 58.3%. The target lesion revascularisation (TLR) rate at six months was 12.9%, at one year 28.3%, and at four years 50.4%. From multivariate analysis, dose < 18 Gy was the most significant predictor of TLR. At four years the cumulative incidence of death was 3.8%, of myocardial infarction 13.4%, and of coronary artery bypass surgery 11.3%. Total vessel occlusion was documented in 12.3% of the patients.
CONCLUSIONS
In the long term follow up of patients after IRT, there are increased adverse cardiac events beyond the first six months.
目的
确定冠状动脉内β射线放射治疗（IRT）后的长期结局。
背景
三级转诊中心。
方法
对连续301例接受IRT治疗的患者进行回顾性分析，确定主要不良心脏事件（MACE）发生率。MACE定义为死亡、心肌梗死或任何再次干预。通过医院记录电子数据库、向患者及转诊医生发放问卷获取长期临床结局。通过向市民事登记处书面查询评估长期生存状况。
结果
平均（标准差）随访3.6（1.2）年。6个月时MACE累积发生率为19.1%，1年时为36.4%，4年时为58.3%。6个月时靶病变血管重建（TLR）率为12.9%，1年时为28.3%，4年时为50.4%。多因素分析显示，剂量<18 Gy是TLR的最显著预测因素。4年时死亡累积发生率为3.8%，心肌梗死为13.4%，冠状动脉搭桥手术为11.3%。12.3%的患者记录有血管完全闭塞。
结论
在IRT治疗患者的长期随访中，6个月后的不良心脏事件有所增加。
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