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β 受体阻滞剂降低了使用依维莫司洗脱支架经皮冠状动脉介入治疗后的靶病变血运重建。

β-Blockers Reduced the Target Lesion Revascularization After Percutaneous Coronary Intervention Using an Everolimus-eluting Stent.

机构信息

Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Cardiology, Toshima Hospital, Tokyo, Japan.

出版信息

In Vivo. 2022 Jan-Feb;36(1):416-423. doi: 10.21873/invivo.12719.

Abstract

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.

摘要

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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