Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan.
J Pediatr. 2010 Jul;157(1):120-6. doi: 10.1016/j.jpeds.2010.01.032. Epub 2010 Mar 20.
To compare the long-term efficacy of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for stenotic lesions after Kawasaki disease.
Questionnaires were sent to pediatricians in Japan in hospitals with 100 or more beds. A total of 1637 questionnaires were sent, and 1347 (82%) were returned. The primary endpoints of the study were the composite of deaths from any cause and the Q-wave myocardial infarction. The secondary endpoints were the repeat-revascularization for the target vessel.
A total of 67 patients underwent PCI and 81 patients underwent CABG. Although the rates of the primary endpoints did not differ between the groups (hazard ratio 1.35 [95% confidence interval 0.29 to 6.32], P=.7), the rate of the secondary endpoints in the PCI group was significantly higher than that in the CABG group (hazard ratio 2.23 [95% confidence interval 1.04 to 4.76], P=.04). The benefit with CABG for the secondary endpoints was notable in patients younger than 12 years old, and who had ischemic change.
PCI after Kawasaki disease resulted in a lower efficacy in comparison to CABG because of increased repeat-revascularization procedures.
比较川崎病后狭窄病变经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）的长期疗效。
向日本有 100 张或更多床位的医院的儿科医生发送问卷。共发送了 1637 份问卷，其中 1347 份（82%）被退回。该研究的主要终点是任何原因导致的死亡和 Q 波心肌梗死的复合终点。次要终点是靶血管的重复血运重建。
共有 67 例患者接受 PCI，81 例患者接受 CABG。尽管两组的主要终点发生率没有差异（危险比 1.35 [95%置信区间 0.29 至 6.32]，P=.7），但 PCI 组的次要终点发生率明显高于 CABG 组（危险比 2.23 [95%置信区间 1.04 至 4.76]，P=.04）。对于年龄小于 12 岁和有缺血改变的患者，CABG 对次要终点的获益更为显著。
与 CABG 相比，川崎病后的 PCI 由于重复血运重建的增加，其疗效较低。
Zotero 插件