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中国南方人群经皮冠状动脉介入治疗后支架内再狭窄的发生率及危险因素。

Incidence and risk factors of in-stent restenosis after percutaneous coronary intervention in patients from southern China.

机构信息

Faculty of Graduate Studies, Guangdong Medical University, Zhanjiang, 524000, People's Republic of China.

Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou, 514031, People's Republic of China.

出版信息

Eur J Med Res. 2022 Jan 22;27(1):12. doi: 10.1186/s40001-022-00640-z.

Abstract

BACKGROUND

In-stent restenosis (ISR) remains a challenge for coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI) with stents, and risk factors for ISR are controversial. This study aimed to investigate the incidence and risk factors of ISR in patients from southern China.

METHODS

In this retrospective study, patients diagnosed as acute coronary syndromes (ACS) and underwent successful PCI with drug-eluting stent (DES) and conducted a follow-up coronary angiography in Center for Cardiovascular Diseases of Meizhou People's Hospital at the period of January 1st, 2016 to January 1st, 2021 were included for analysis. The clinical and angiographic factors were compared between patients in ISR ( +) and ISR (-) groups. The association between variables and ISR was evaluated by multivariate logistic regression model.

RESULT

A total of 341 ACS patients who had been installed at least 1 stent were included in this study. The follow-up time was 34.2 ± 17.2 months. During the follow-up period, 62 (18.2%) patients experienced ISR, and the average time for ISR was 32.8 months; the incidence of ISR for left main coronary artery, left anterior descending coronary artery, left circumflex artery coronary artery and right coronary artery were 6.7%, 20.9%, 19.4% and 14.4%, respectively; left ventricular ejection fraction (LVEF), stent number, stent type, statin therapy, antiplatelet therapy were significantly different between patients in ISR ( +) and ISR (-) group. Multivariate logistic analysis suggested that LVEF and stent number were significantly correlated with ISR.

CONCLUSION

Our study revealed the incidence and risk factors of ISR in patients from southern China. Our data suggested that LVEF and stent number were independent risk factors associated with ISR.

摘要

背景

经皮冠状动脉介入治疗(PCI)置入支架后,冠状动脉疾病(CAD)患者的支架内再狭窄(ISR)仍然是一个挑战,其危险因素存在争议。本研究旨在探讨中国南方患者 ISR 的发生率和危险因素。

方法

在这项回顾性研究中,纳入了 2016 年 1 月 1 日至 2021 年 1 月 1 日在梅州市人民医院心血管疾病中心诊断为急性冠脉综合征(ACS)并成功接受药物洗脱支架(DES)PCI 治疗且进行了随访冠状动脉造影的患者进行分析。比较 ISR(+)和 ISR(-)组患者的临床和血管造影因素。采用多变量 logistic 回归模型评估变量与 ISR 的相关性。

结果

本研究共纳入 341 例至少植入 1 枚支架的 ACS 患者。随访时间为 34.2±17.2 个月。在随访期间,62 例(18.2%)患者发生 ISR,ISR 的平均时间为 32.8 个月;左主干、左前降支、左回旋支和右冠状动脉的 ISR 发生率分别为 6.7%、20.9%、19.4%和 14.4%;左心室射血分数(LVEF)、支架数量、支架类型、他汀类药物治疗、抗血小板治疗在 ISR(+)和 ISR(-)组患者之间存在显著差异。多变量 logistic 分析表明,LVEF 和支架数量与 ISR 显著相关。

结论

本研究揭示了中国南方患者 ISR 的发生率和危险因素。我们的数据表明,LVEF 和支架数量是与 ISR 相关的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d9/8783476/6490433e636a/40001_2022_640_Fig1_HTML.jpg

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