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血管疾病记录病程(Reccord)注册研究中的患者特征:与Voyager Pad血管内治疗队列的比较。

Patient Characteristics in the Recording Courses of Vascular Diseases (Reccord) Registry: Comparison with the Voyager Pad Endovascular Cohort.

作者信息

Czihal Michael, Malyar Nasser, Stausberg Jürgen, Hoffmann Ulrich

机构信息

Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Ziemssenstraße 5, 80336 Munich, Germany.

Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital, 48149 Muenster, Germany.

出版信息

J Cardiovasc Dev Dis. 2023 Mar 10;10(3):115. doi: 10.3390/jcdd10030115.

Abstract

BACKGROUND

To compare the characteristics of a "real world" population included in a prospective registry to patients enrolled in a randomized, controlled trial (RCT) after endovascular revascularization (EVR) for symptomatic peripheral artery disease (PAD).

METHODS

The RECcording COurses of vasculaR Diseases (RECCORD) registry is an observational registry prospectively recruiting patients undergoing EVR for symptomatic PAD in Germany. VOYAGER PAD was an RCT which demonstrated the superiority of rivaroxaban and aspirin versus aspirin to reduce major cardiac and ischemic limb events following infrainguinal revascularization for symptomatic PAD. For this exploratory analysis, the clinical characteristics of 2.498 patients enrolled in RECCORD and of 4.293 patients from VOYAGER PAD who underwent EVR were compared.

RESULTS

The rate of patients aged ≥ 75 years was considerably higher in the registry (37.7 vs. 22.5%). More patients in the registry had undergone previous EVR (50.7 vs. 38.7%) or suffered from critical limb threatening ischemia (24.3 vs. 19.5%). Registry patients were more commonly active smokers (51.8 vs. 33.6%), but less frequently suffered from diabetes mellitus (36.4 vs. 44.7%). While statins (70.5 vs. 81.7%) were less frequently used, antiproliferative catheter technologies (45.6 vs. 31.4%) and postinterventional dual antiplatelet therapy (64.5 vs. 53.6%) were more commonly applied in the registry.

CONCLUSIONS

There were many similarities but some clinically meaningful differences in clinical characteristics between PAD patients who underwent EVR and were included in a nationwide registry and PAD patients from the VOYAGER PAD trial.

摘要

背景

比较前瞻性登记研究中纳入的“真实世界”人群与因症状性外周动脉疾病(PAD)接受血管内血运重建术(EVR)后纳入随机对照试验(RCT)的患者的特征。

方法

血管疾病记录(RECCORD)登记研究是一项观察性登记研究,前瞻性纳入德国因症状性PAD接受EVR的患者。VOYAGER PAD是一项RCT,该研究表明利伐沙班联合阿司匹林对比阿司匹林在降低症状性PAD患者股腘以下血运重建术后主要心脏和缺血性肢体事件方面具有优越性。在这项探索性分析中,比较了RECCORD登记研究中纳入的2498例患者以及VOYAGER PAD试验中接受EVR的4293例患者的临床特征。

结果

登记研究中≥75岁患者的比例显著更高(37.7%对22.5%)。登记研究中有更多患者曾接受过EVR(50.7%对38.7%)或患有肢体严重威胁性缺血(24.3%对19.5%)。登记研究中的患者更常为现吸烟者(51.8%对33.6%),但患糖尿病的频率较低(36.4%对44.7%)。虽然他汀类药物的使用频率较低(70.5%对81.7%),但登记研究中抗增殖导管技术(45.6%对31.4%)和介入后双联抗血小板治疗的应用更为普遍(64.5%对53.6%)。

结论

接受EVR并纳入全国性登记研究的PAD患者与VOYAGER PAD试验中的PAD患者在临床特征上有许多相似之处,但也存在一些具有临床意义的差异。

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