Soeiro Alexandre de Matos, Scanavini Filho Marco Antônio, Bossa Aline Siqueira, Zullino Cindel Nogueira, Soeiro Maria Carolina F Almeida, Leal Tatiana Carvalho Andreucci T, Serrano Carlos Vicente, Hajjar Ludhmila Abrahão, Kalil Filho Roberto, Oliveira Múcio Tavares
Instituto do Coração (InCor), Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
Arq Bras Cardiol. 2016 Dec;107(6):550-556. doi: 10.5935/abc.20160176.
A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS).
Retrospective, unicentric, observational study.
To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I) versus those without residual lesions in other coronary artery beds (group II). The study included 580 patients (284 in group I and 296 in group II) between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/angina, death, heart failure, and need for reintervention). The comparison between groups was performed using the chi-square test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months.
The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p = 0.76).
The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions.
最近发表的一项研究对急性冠状动脉综合征（ACS）患者非罪犯病变的经皮治疗必要性提出了质疑。
回顾性、单中心观察性研究。
分析罪犯血管接受治疗的患者的长期结局，比较非罪犯血管仍有明显残余病变的患者（I组）与其他冠状动脉床无残余病变的患者（II组）。该研究纳入了2010年5月至2013年5月期间的580例患者（I组284例，II组296例）。我们获取了人口统计学和临床数据，以及患者接受冠状动脉治疗的相关信息。在统计分析中，主要结局包括复合事件（再梗死/心绞痛、死亡、心力衰竭和再次干预需求）。组间比较采用卡方检验和方差分析。长期分析采用Kaplan-Meier方法，平均随访9.86个月。
I组平均年龄为63岁，II组为62岁。在长期随访中，I组和II组的复合事件无显著差异（分别为31.9%和35.6%，p = 0.76）。
仅治疗罪犯血管的策略似乎是安全的。在本研究中，与无其他阻塞的患者相比，有明显病变的患者在复合终点方面未观察到长期差异。
