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中国糖尿病患者与非糖尿病患者药物洗脱支架植入术后临床结局的比较:一项回顾性研究。

Comparison of clinical outcomes after drug-eluting stent implantation in diabetic versus nondiabetic patients in China: A retrospective study.

作者信息

Jiang Yong-Jin, Han Wei-Xing, Gao Chao, Feng Jun, Chen Zheng-Fei, Zhang Jing, Luo Chun-Miao, Pan Jian-Yuan

机构信息

Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei) Department of Cardiology, the first Affiliated Hospital of Anhui Medical University, Hefei, P.R. China.

出版信息

Medicine (Baltimore). 2017 Apr;96(17):e6647. doi: 10.1097/MD.0000000000006647.

Abstract

Diabetes mellitus (DM) has been proved to be a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Drug-eluting stents (DESs) could reduce the adverse events in DM patients. In this study, we aimed to analyze the clinical outcome after DES implantation in diabetic versus nondiabetic patients in China. Totally, 200 Chinese DM patients and 400 Chinese non-DM patients were enrolled in this retrospective study. Compared with non-DM patients, DM patients were more likely to have a higher incidence of cardiac death (3.5% vs. 1.0%, P = .048), stent thrombosis (2.5% vs. 0.5%, P = .044), target lesion revascularization (6.0% vs. 1.8%, P = .005), target vessel failure (15.5% vs. 8.0%, P < .001), target lesion failure (14.0% vs. 4.3%, P < .001), myocardial infarction (4.5% vs. 1.5%, P = .030), and major adverse cardiac events (12.5% vs. 5.0%, P = .001) at 2-year follow-up. However, the incidence of target vessel revascularization (7.5% vs. 5.5%, P = .340) was similar between DB and non-DB patients. Patients with DB (hazard ratio [HR] = 2.54, P = .001), older than 80 years (HR = 1.33, P = .027) with hypercholesterolemia (HR = 1.03, P < .001), serum creatinine >177 μmol/L (HR = 3.04, P = .011), a history of cerebral vascular accident (HR = 4.29, P = .010), or a history of myocardial infarction (HR = 31.4, P < .001) were more likely to experience adverse events. In China, DM could also be served as an independent predictor of adverse outcomes after DES implantation. These patients should be reexamined more frequently.

摘要

糖尿病(DM)已被证明是经皮冠状动脉介入治疗(PCI)后不良结局的一个预测指标。药物洗脱支架(DES)可降低糖尿病患者的不良事件。在本研究中,我们旨在分析在中国糖尿病患者与非糖尿病患者中植入DES后的临床结局。本项回顾性研究共纳入了200例中国糖尿病患者和400例中国非糖尿病患者。与非糖尿病患者相比,糖尿病患者在2年随访时更有可能出现较高的心源性死亡发生率(3.5%对1.0%,P = 0.048)、支架血栓形成发生率(2.5%对0.5%,P = 0.044)、靶病变血运重建发生率(6.0%对1.8%,P = 0.005)、靶血管失败发生率(15.5%对8.0%,P < 0.001)、靶病变失败发生率(14.0%对4.3%,P < 0.001)、心肌梗死发生率(4.5%对1.5%,P = 0.030)以及主要不良心脏事件发生率(12.5%对5.0%,P = 0.001)。然而,糖尿病患者与非糖尿病患者之间的靶血管血运重建发生率(7.5%对5.5%,P = 0.340)相似。患有糖尿病(风险比[HR]=2.54,P = 0.001)、年龄大于80岁(HR = 1.33,P = 0.027)、患有高胆固醇血症(HR = 1.03,P < 0.001)、血清肌酐>177μmol/L(HR = 3.04,P = 0.011)、有脑血管意外病史(HR = 4.29,P = 0.010)或有心肌梗死病史(HR = 31.4,P < 0.001)的患者更有可能发生不良事件。在中国,糖尿病也可作为DES植入后不良结局的独立预测指标。这些患者应更频繁地接受复查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a808/5413230/585fd208c3bd/medi-96-e6647-g004.jpg

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