术前冠状动脉侧支循环对冠状动脉旁路移植术后心脏相关事件的影响。
The Effects of Preoperative Coronary Collateral Circulation on Cardiac-Related Events after Coronary Artery Bypass Graft Surgery.
机构信息
Department of Cardiology, Adnan Menderes University, Aydin, Turkey.
出版信息
Braz J Cardiovasc Surg. 2021 Feb 1;36(1):25-31. doi: 10.21470/1678-9741-2019-0375.
INTRODUCTION
This study aimed to evaluate the effects of coronary collateral circulation (CCC) in patients who had undergone coronary artery bypass grafting (CABG).
METHODS
A total of 127 patients who had undergone CABG (2011-2013) were enrolled into this study and follow-up was obtained by phone contact. Patients were categorized into two groups according to preoperative CCC using the Rentrop method. Percutaneous coronary intervention (PCI), recurrent myocardial infarction (MI), stroke, heart failure (HF), and mortality rates were compared between groups. Clinical outcome was defined as combined end point including death, PCI, recurrent MI, stroke, and HF.
RESULTS
Sixty-two of 127 patients had poor CCC and 65 had good CCC. There were no differences in terms of PCI, recurrent MI, and HF between the groups. Stroke (seven of 62 [11.3%] and one of 65 [1.5%], P=0.026) and mortality (19 of 62 [30.6%] and 10 of 65 [15.4%], P=0.033) rates were significantly higher in poor CCC group than in good CCC group. In Kaplan-Meier analysis, survival time was not statistically different between the groups. Presence of poor CCC resulted in a significantly higher combined end point incidence (P=0.011).
CONCLUSION
Stroke, mortality rates, and combined end point incidence were significantly higher in poor CCC patients than in the good CCC group.
简介
本研究旨在评估冠状动脉侧支循环（CCC）对接受冠状动脉旁路移植术（CABG）的患者的影响。
方法
共纳入 127 例于 2011 年至 2013 年期间接受 CABG 的患者，并通过电话联系进行随访。根据 Rentrop 法，将患者分为术前 CCC 两组。比较两组之间经皮冠状动脉介入治疗（PCI）、复发性心肌梗死（MI）、卒中和心力衰竭（HF）的发生率以及死亡率。临床结局定义为包括死亡、PCI、复发性 MI、卒中和 HF 的复合终点。
结果
127 例患者中 62 例 CCC 较差，65 例 CCC 较好。两组间 PCI、复发性 MI 和 HF 发生率无差异。卒中（62 例中的 7 例[11.3%]和 65 例中的 1 例[1.5%]，P=0.026）和死亡率（62 例中的 19 例[30.6%]和 65 例中的 10 例[15.4%]，P=0.033）在 CCC 较差组显著高于 CCC 较好组。在 Kaplan-Meier 分析中，两组间的生存时间无统计学差异。存在 CCC 较差会导致复合终点发生率显著升高（P=0.011）。
结论
与 CCC 较好组相比，CCC 较差的患者卒中、死亡率和复合终点发生率显著更高。
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