韩国接受旋转血管成形术的患者中糖尿病对围手术期和 18 个月临床结局的影响：ROCK 注册研究结果。
Impact of diabetes mellitus on periprocedural and 18-month clinical outcomes in Korean patients requiring rotational atherectomy: results from the ROCK Registry.
机构信息
From the Department of Internal Medicine, The Catholic University of Korea, St. Vincent`s Hospital, Suwon, Gyeonggi-do, Republic of Korea.
From the Department of Internal Medicine, Daejon Saint Mary's Hospital, Daejon, Republic of Korea.
出版信息
Ann Saudi Med. 2022 Sep-Oct;42(5):291-298. doi: 10.5144/0256-4947.2022.291. Epub 2022 Oct 6.
BACKGROUND
Diabetes mellitus (diabetes) increases the risk of severe coronary artery calcification, which increases the complexity of percutaneous coronary intervention requiring rotational atherectomy (RA) by interfering with lesion preparation, and limiting final stent expansion.
OBJECTIVE
Investigate 30-day and 18-month clinical outcomes in patients with and without diabetes treated with percutaneous coronary intervention requiring RA.
DESIGN
Medical record review SETTING: Multicenter registry in South Korea PATIENTS AND METHODS: The ROtational atherectomy in Calcified lesions in Korea (ROCK) registry was a large, retrospective, multicenter study to assess RA treatment of severe coronary artery calcification.
MAIN OUTCOME MEASURES
The primary endpoint was target-vessel failure including cardiac death, target-vessel myocardial infarction, and target-vessel revascularization.
SAMPLE SIZE
540 patients followed for a median of 16.1 months.
RESULTS
Of the 540 patients, 305 had diabetes (56.5%). The diabetes group had a significantly higher frequency of multivessel disease; comorbidities such as hypertension, dyslipidemia, and chronic kidney disease; and lower ejection fraction of the left ventricle compared to the non-diabetes group (n=235). There were no significant differences in procedure success and complications observed between the two groups. Target vessel failure at 30 days between the diabetes and non-diabetes groups was not statistically significant in a multivariate Cox regression analysis (1.6% vs. 2.6%, adjusted hazard ratio [HR] 0.595, 95% confidence interval [CI] 0.154-2.300, =.451). During an 18-month follow-up, the risk of target vessel failure was higher (12.5% vs. 8.9%) but the difference was not statistically significant (adjusted HR 1.393, 95% CI 0.782-2.482, =.260).
CONCLUSIONS
Patients with diabetes have a risk of complications comparable to patients without diabetes, and 30-day and 18-month clinical outcomes are similar in severe coronary artery calcification requiring RA, despite having more comorbidities.
LIMITATIONS
Retrospective design. Sample size not based on power calculation.
CONFLICT OF INTEREST
None.
背景
糖尿病会增加严重冠状动脉钙化的风险，这会通过干扰病变准备和限制最终支架扩张，增加需要旋磨术（RA）的经皮冠状动脉介入治疗的复杂性。
目的
调查需要接受 RA 治疗的糖尿病患者和非糖尿病患者的 30 天和 18 个月的临床结局。
设计
病历回顾
地点
韩国多中心登记处
患者和方法
韩国旋磨术治疗严重冠状动脉钙化（ROCK）登记研究是一项大型回顾性多中心研究，旨在评估 RA 治疗严重冠状动脉钙化。
主要观察指标
主要终点是靶血管失败，包括心源性死亡、靶血管心肌梗死和靶血管血运重建。
样本量
540 例患者中位随访 16.1 个月。
结果
在 540 例患者中，305 例患有糖尿病（56.5%）。与非糖尿病组相比，糖尿病组多支血管病变、合并症（如高血压、血脂异常和慢性肾脏病）和左心室射血分数明显更高（n=235）。两组间手术成功率和并发症无显著差异。多因素 Cox 回归分析显示，30 天的靶血管失败在糖尿病组和非糖尿病组之间无统计学意义（1.6% vs. 2.6%，调整后危险比[HR]0.595，95%置信区间[CI]0.154-2.300，P=0.451）。在 18 个月的随访中，靶血管失败的风险更高（12.5% vs. 8.9%），但差异无统计学意义（调整后 HR 1.393，95% CI 0.782-2.482，P=0.260）。
结论
尽管糖尿病患者合并症更多，但与非糖尿病患者相比，糖尿病患者并发症风险相当，且在需要 RA 的严重冠状动脉钙化中，30 天和 18 个月的临床结局相似。
局限性
回顾性设计。样本量不是基于功效计算的。
利益冲突
无。
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