JOCRI研究（JOCRIED研究）的15年随访结果：非体外循环与体外循环下多支冠状动脉血运重建的随机对照比较
15-year outcomes of the JOCRI study (JOCRIED study): a randomised comparison of off-pump and on-pump multiple arterial coronary revascularisation.
作者信息
Tadokoro Naoki, Fukushima Satsuki, Minami Kimito, Shimahara Yusuke, Kawamoto Naonori, Kakuta Takashi, Numata Satoshi, Yaku Hitoshi, Takemura Hirofumi, Iino Kenji, Ochi Masami, Ishii Yosuke, Wada Hideichi, Minematsu Noritoshi, Shimizu Hideyuki, Kobayashi Junjiro, Fujita Tomoyuki
机构信息
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Osaka, Japan.
Department of Cardiovascular Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
出版信息
Gen Thorac Cardiovasc Surg. 2023 Mar;71(3):151-157. doi: 10.1007/s11748-022-01854-y. Epub 2022 Aug 11.
OBJECTIVE
The Japanese Off-Pump Coronary Revascularization Investigation (JOCRI) study reported a non-significant difference in early outcomes and graft patency between off-pump coronary artery bypass grafting and on-pump coronary artery bypass grafting in 2005. The JOCRIED study aimed to review the long-term outcomes of the JOCRI study participants.
METHOD AND RESULTS
The JOCRIED study enrolled 123 of the JOCRI study participants completing the clinical follow-up between August 2018 and August 2020; 61 patients in the off-pump group and 62 patients in the on-pump group. The follow-up period was 13.8 ± 2.8 years. The groups were compared regarding mortality, the incidence of major adverse cardiac and cerebrovascular events and repeat revascularisation. The 15-year cumulative survival rate (off-pump vs on-pump, respectively; 77.7% vs 75.3%; p = 0.85), major adverse events-free survival rate (62.5% vs 55.6%; p = 0.27) and repeat revascularisation-free rate (84.8% vs 78.0%; p = 0.16) were not significantly different between the two groups. Revascularisation was the most common major adverse events in the JOCRIED participants. Although percutaneous coronary intervention was performed in 8 patients (13%) in the off-pump group and in 14 patients (23%) in the on-pump group (p = 0.23), no patients underwent redo coronary artery bypass grafting.
CONCLUSIONS
Off-pump coronary artery bypass grafting provides comparable 15-year outcomes to on-pump coronary artery bypass grafting.
目的
日本非体外循环冠状动脉血运重建研究（JOCRI）在2005年报告了非体外循环冠状动脉旁路移植术与体外循环冠状动脉旁路移植术在早期结局和移植物通畅率方面无显著差异。JOCRIED研究旨在回顾JOCRI研究参与者的长期结局。
方法与结果
JOCRIED研究纳入了123名在2018年8月至2020年8月期间完成临床随访的JOCRI研究参与者；非体外循环组61例患者，体外循环组62例患者。随访期为13.8±2.8年。比较两组在死亡率、主要不良心脑血管事件发生率和再次血运重建方面的情况。两组的15年累积生存率（非体外循环组与体外循环组分别为77.7%对75.3%；p = 0.85）、无主要不良事件生存率（62.5%对55.6%；p = 0.27）和无再次血运重建率（84.8%对78.0%；p = 0.16）无显著差异。血运重建是JOCRIED参与者中最常见的主要不良事件。尽管非体外循环组有8例患者（13%）接受了经皮冠状动脉介入治疗，体外循环组有14例患者（23%）接受了该治疗（p = 0.23），但没有患者接受再次冠状动脉旁路移植术。
结论
非体外循环冠状动脉旁路移植术与体外循环冠状动脉旁路移植术的15年结局相当。
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