Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Cardiology, Toshima Hospital, Tokyo, Japan.
In Vivo. 2022 Jan-Feb;36(1):416-423. doi: 10.21873/invivo.12719.
BACKGROUND/AIM: The effect of β-adrenergic blockers on everolimus-eluting stent (EES) implantation is unknown. We aimed to investigate how β-blockers affect the outcomes of EES by using the Tokyo-MD PCI registry data and analyse real-world data in this drug-eluting stent era in Japan. PATIENTS AND METHODS: We selected 1,899 patients who underwent EES implantation. We compared patients with β-blocker administration versus those without, at follow-up regarding the incidence rate of ischemia-driven target lesion revascularization (ID-TLR), all-cause death, cardiac death, acute myocardial infarction (AMI), and stent thrombosis (ST). RESULTS: Patients in the β-blocker group had higher coronary risks than those in the non-β-blocker group. Although no significant difference was observed in the five-year incidence of all-cause death, cardiac death, AMI, and ST between the two groups, the incidence of ID-TLR was significantly lower in the β-blocker group (4.5% vs. 6.6%; p=0.04). β-Blocker administration (hazard ratio=0.61; p=0.016) was negatively associated with ID-TLR via multivariate analysis. CONCLUSION: β-Blocker administration reduced ID-TLR after percutaneous coronary intervention using an EES despite the greater comorbid risks and more severe disease lesions.
背景/目的:β-肾上腺素能阻滞剂对依维莫司洗脱支架(EES)植入的影响尚不清楚。我们旨在使用东京-MD PCI 注册数据研究β受体阻滞剂如何影响 EES 的结果,并分析日本这个药物洗脱支架时代的真实世界数据。 患者和方法:我们选择了 1899 名接受 EES 植入术的患者。我们比较了在随访期间使用β受体阻滞剂的患者与未使用β受体阻滞剂的患者,比较缺血驱动的靶病变血运重建(ID-TLR)、全因死亡、心脏死亡、急性心肌梗死(AMI)和支架血栓形成(ST)的发生率。 结果:β受体阻滞剂组患者的冠状动脉风险高于非β受体阻滞剂组。尽管两组间全因死亡、心脏死亡、AMI 和 ST 的五年发生率无显著差异,但β受体阻滞剂组的 ID-TLR 发生率显著较低(4.5% vs. 6.6%;p=0.04)。多因素分析显示,β受体阻滞剂的使用(风险比=0.61;p=0.016)与 ID-TLR 呈负相关。 结论:尽管存在更大的合并症风险和更严重的疾病病变,β受体阻滞剂的使用仍可降低 EES 经皮冠状动脉介入治疗后的 ID-TLR。
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