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经皮冠状动脉介入治疗后日本稳定型心绞痛的近期特征与结局:一项使用信金数据库的观察性队列研究

Recent characteristics and outcomes of Japanese stable angina pectoris after percutaneous coronary intervention. An observational cohort study using the Shinken Database.

作者信息

Kaneko Hidehiro, Yajima Junji, Oikawa Yuji, Tanaka Shingo, Fukamachi Daisuke, Suzuki Shinya, Sagara Koichi, Otsuka Takayuki, Matsuno Shunsuke, Funada Ryuichi, Kano Hiroto, Uejima Tokuhisa, Koike Akira, Nagashima Kazuyuki, Kirigaya Hajime, Sawada Hitoshi, Aizawa Tadanori, Yamashita Takeshi

机构信息

Department of Cardiovascular Medicine, The Cardiovascular Institute.

出版信息

Int Heart J. 2013;54(6):335-40. doi: 10.1536/ihj.54.335.

Abstract

The mortality and morbidity of patients with stable angina pectoris (SAP) after percutaneous coronary intervention (PCI) in Japan differ from those in Western countries, although Japanese data are limited. We selected from the Shinken Database a single-hospital-based cohort of Japanese patients (n = 15,227) who visited The Cardiovascular Institute between 2004 and 2010 to undergo PCI. We followed-up the patients after PCI. A major adverse cardiac event (MACE) was defined as composite endpoints including all-cause death, acute myocardial infarction (AMI), and target-lesion revascularization (TLR). This study included 747 SAP patients (median follow-up period, 1,000 ± 703 days). The all cause mortality rate in SAP was 1.3% at 1 year, 2.7% at 3 years, and 6.1% at 5 years. The AMI rate was 0.5% at 1 year, 1.1% at 3 years, and 3.0% at 5 years, and the MACE rate was 14.0% at 1 year, 17.6% at 3 years, and 25.6% at 5 years. Moreover, new lesion PCI and heart failure admission continued to occur beyond 1 year after PCI without attenuation of their annual incidences up to 5 years. Multivariate analysis showed that poor left ventricular ejection fraction, chronic kidney disease (CKD), and absence of statin treatment were independent predictors of all-cause death of SAP patients after PCI. The results of the present study revealed the characteristics and long-term outcomes of Japanese SAP patients after PCI. The results of the present study suggest cardiorenal interaction and statin treatment play important roles in the long-term outcomes of Japanese CAD patients treated by PCI.

摘要

在日本,尽管相关数据有限,但稳定性心绞痛(SAP)患者经皮冠状动脉介入治疗(PCI)后的死亡率和发病率与西方国家有所不同。我们从“振新数据库”中选取了一个以单家医院为基础的日本患者队列(n = 15227),这些患者于2004年至2010年间前往心血管研究所接受PCI治疗。我们在PCI术后对患者进行随访。主要不良心脏事件(MACE)被定义为包括全因死亡、急性心肌梗死(AMI)和靶病变血管重建(TLR)的复合终点。本研究纳入了747例SAP患者(中位随访期为1000±703天)。SAP患者的全因死亡率在1年时为1.3%,3年时为2.7%,5年时为6.1%。AMI发生率在1年时为0.5%,3年时为1.1%,5年时为3.0%,MACE发生率在1年时为14.0%,3年时为17.6%,5年时为25.6%。此外,但PCI术后1年以上新病变PCI和心力衰竭入院仍持续发生,且其年发病率直至5年都未减弱。多变量分析显示,左心室射血分数低、慢性肾脏病(CKD)以及未接受他汀类药物治疗是PCI术后SAP患者全因死亡的独立预测因素。本研究结果揭示了日本SAP患者PCI术后的特征和长期预后。本研究结果表明,心肾相互作用和他汀类药物治疗在接受PCI治疗的日本CAD患者的长期预后中起着重要作用。

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