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多支复杂冠状动脉疾病的最佳治疗

Optimal treatment of multivessel complex coronary artery disease.

作者信息

Sun Haihui, Cui Lianqun

机构信息

Department of Cardiology, The Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China ; Department of Cardiology, The Central Hospital of Tai'an, Tai'an, Shandong 271000, P.R. China.

Department of Cardiology, The Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.

出版信息

Exp Ther Med. 2014 Jun;7(6):1563-1567. doi: 10.3892/etm.2014.1630. Epub 2014 Mar 21.

DOI:10.3892/etm.2014.1630
PMID:24926344
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4043626/
Abstract

The aim of the present study was to investigate major cardiac events and the similarities and differences of medical costs among patients with multivessel complex coronary artery disease (MCCAD) during the three-year follow-up. The MCCAD patients had undergone single complete revascularization (CR), fractionated revascularization (FR) or partial revascularization (PR) and the present study aimed to screen the optimal treatment program. A total of 2,309 MCCAD patients who had been treated at a single center in the last decade, among which 1,020 cases underwent single CR, 856 cases successively underwent FR and 433 cases only underwent PR, were followed-up for three years. Major cardiac events, including all-cause mortality, myocardial infarction, severe heart failure, rehospitalization and revascularization (coronary artery bypass grafting and coronary stent reimplantation), were set as the end points. In addition, the three-year medical costs associated with heart disease were analyzed. The three-year cardiac event rate in the CR group (17%) was significantly lower compared with the other two groups and the average three-year medical costs in the CR group (62,100 RMB) were significantly lower than those in the other two groups. Therefore, under permissive conditions, single CR is the optimal and most economical treatment strategy for patients with MCCAD.

摘要

本研究的目的是调查多支复杂冠状动脉疾病(MCCAD)患者在三年随访期间的主要心脏事件以及医疗费用的异同。MCCAD患者接受了单次完全血运重建(CR)、分次血运重建(FR)或部分血运重建(PR),本研究旨在筛选出最佳治疗方案。对过去十年在单一中心接受治疗的2309例MCCAD患者进行了三年随访,其中1020例接受了单次CR,856例先后接受了FR,433例仅接受了PR。主要心脏事件,包括全因死亡率、心肌梗死、严重心力衰竭、再次住院和血运重建(冠状动脉搭桥术和冠状动脉支架再植入)被设定为终点。此外,还分析了与心脏病相关的三年医疗费用。CR组的三年心脏事件发生率(17%)明显低于其他两组,CR组的三年平均医疗费用(62100元)明显低于其他两组。因此,在允许的条件下,单次CR是MCCAD患者的最佳且最经济的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d18/4043626/06de572503af/ETM-07-06-1563-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d18/4043626/06de572503af/ETM-07-06-1563-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d18/4043626/06de572503af/ETM-07-06-1563-g00.jpg

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Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction.
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