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球囊血管成形术与支架置入术在 ST 段抬高型心肌梗死患者后续冠状动脉旁路移植术前的比较。

Balloon Angioplasty Versus Stenting in Patients With ST-Elevated Myocardial Infarction Before Subsequent Coronary Artery By-Pass Grafting.

机构信息

Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.

Cardiovascular Surgery Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.

出版信息

Angiology. 2021 Oct;72(9):836-841. doi: 10.1177/00033197211007713. Epub 2021 Apr 20.

Abstract

Decision of revascularization strategy in patients who require coronary artery bypass grafting (CABG) following primary percutaneous coronary interventions (PCI) is challenging due to the pros and cons of only-ballooning and stenting. In this study, we aimed to compare the outcomes of only-balloon-angioplasty to stenting in primary PCI in patients with ST elevated myocardial infarction (STEMI) who required a subsequent CABG. We retrospectively analyzed 350 consecutive STEMI patients who needed CABG in addition to primary balloon angioplasty (n = 160) and stenting strategy (n = 190). In-hospital and 5-year outcomes of the patients were compared between the 2 groups. In-hospital mortality rates in the ballooning and stenting groups were not nonsignificantly different (11.2% vs 9.5%, respectively, = .59); 5-year mortality rates were also similar between the 2 groups (9.2% vs 8.7%, = .89). Additionally, major bleeding rates (3.8% vs 6.3%, = .28) did not differ between the 2 groups. In conclusion, our study showed no significant difference in-hospital and long-term mortality rates in patients who require CABG after primary PCI irrespective of the revascularization strategy.

摘要

对于需要经皮冠状动脉介入治疗(PCI)后进行冠状动脉旁路移植术(CABG)的患者,决定采用单纯球囊扩张还是支架置入的血运重建策略具有挑战性,因为这两种方法各有优缺点。在这项研究中,我们旨在比较直接 PCI 治疗 ST 段抬高型心肌梗死(STEMI)患者中,单纯球囊血管成形术与支架置入术在需要后续 CABG 患者中的疗效。我们回顾性分析了 350 例连续 STEMI 患者,这些患者在接受直接球囊血管成形术(n = 160)和支架置入术(n = 190)后需要 CABG。比较了两组患者的住院期间和 5 年结局。单纯球囊扩张组和支架置入组的住院死亡率无显著差异(分别为 11.2%和 9.5%, =.59);两组 5 年死亡率也相似(分别为 9.2%和 8.7%, =.89)。此外,两组之间主要出血发生率(3.8% vs 6.3%, =.28)无差异。总之,我们的研究表明,在直接 PCI 后需要 CABG 的患者中,无论采用何种血运重建策略,其住院期间和长期死亡率均无显著差异。

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