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药物洗脱球囊与药物洗脱支架治疗急性心肌梗死合并癌症患者的比较。

Comparisons of drug-eluting balloon versus drug-eluting stent for the treatment of cancer patients presenting with acute myocardial infarction.

机构信息

Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China.

Department of Cardiology, Heze Municipal Hospital, No. 2888, Caozhou Road, Mudan District, Heze, 274000, Shandong, China.

出版信息

Eur J Med Res. 2023 Sep 9;28(1):334. doi: 10.1186/s40001-023-01316-y.

Abstract

BACKGROUND

Treatment for cancer patients presenting with acute myocardial infarction (AMI) remains challenging. The objective of the study was to investigate the safety and efficiency of drug eluting balloon (DEB) versus drug eluting stent (DES) in this high-risk group.

METHODS

Between 1st January 2017 and 1st January 2022, cancer patients admitted to Beijing Chaoyang Hospital with AMI were retrospectively enrolled. The primary endpoint was major adverse cardiovascular event (MACE). The secondary endpoints included major bleeding events, heart failure and cardiac complications.

RESULTS

A total of 164 cancer patients presenting with AMI were included in the final analysis. Patients treated with DEB had a numerically lower rate of MACE than those treated with DES during a median follow-up of 21.8 months (22.9% vs. 37.1%, p = 0.23). Patients treated with DEB had a trend towards lower rate of major bleeding events than patients treated with DES (6.3% vs. 18.1%, HR 2.96, 95% CI [0.88, 9.92], p = 0.08). There were no significant differences between the two groups with regards to the rate of heart failure (4.2% vs. 9.5%, p = 0.32) and cardiac complications (0.0% vs. 2.6%, p = 0.56).

CONCLUSIONS

The present study demonstrated that in cancer patients with AMI, DEB had a trend towards lower rate of major bleeding events and a numerically lower rate of MACE compared with DES.

摘要

背景

急性心肌梗死(AMI)合并癌症患者的治疗仍然具有挑战性。本研究旨在探讨药物洗脱球囊(DEB)与药物洗脱支架(DES)在这一高危人群中的安全性和疗效。

方法

回顾性纳入 2017 年 1 月 1 日至 2022 年 1 月 1 日期间因 AMI 入住北京朝阳医院的癌症患者。主要终点是主要不良心血管事件(MACE)。次要终点包括主要出血事件、心力衰竭和心脏并发症。

结果

共纳入 164 例 AMI 合并癌症的患者进行最终分析。在中位随访 21.8 个月时,与 DES 相比,DEB 治疗患者的 MACE 发生率较低(22.9%比 37.1%,p=0.23)。与 DES 相比,DEB 治疗患者的主要出血事件发生率呈下降趋势(6.3%比 18.1%,HR 2.96,95%CI [0.88, 9.92],p=0.08)。两组心力衰竭(4.2%比 9.5%,p=0.32)和心脏并发症(0.0%比 2.6%,p=0.56)发生率无显著差异。

结论

本研究表明,在 AMI 合并癌症的患者中,与 DES 相比,DEB 治疗有较低的主要出血事件发生率和较低的 MACE 发生率趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9ab/10492280/6a9c6751332d/40001_2023_1316_Fig1_HTML.jpg

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