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药物涂层球囊经皮冠状动脉介入治疗后慢性肾脏病的预后影响

Prognostic Impact of Chronic Kidney Disease After Percutaneous Coronary Intervention with Drug-Coated Balloons.

作者信息

Takahashi Tetsuya, Watanabe Tetsu, Toyoshima Mashu, Katawaki Wataru, Toshima Taku, Kumagai Yu, Yamanaka Tamon, Watanabe Masafumi

机构信息

The Department of Cardiology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-0861, Japan.

The Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata 990-9585, Japan.

出版信息

J Clin Med. 2025 Mar 28;14(7):2317. doi: 10.3390/jcm14072317.

Abstract

: A drug-coated balloon (DCB) is an emerging treatment technology for percutaneous coronary intervention (PCI). However, the prognostic factors of PCI with a DCB remain fully determined. Chronic kidney disease (CKD) is an independent predictor of adverse outcomes in patients with coronary artery disease (CAD) who underwent PCI. The aim of this present study was to clarify the impact of CKD on prognosis in CAD patients who underwent PCI with a DCB. : We enrolled 252 consecutive patients with CAD who underwent PCI with a DCB from 2015 to 2023. The endpoints of this study were composite events including all-cause death, myocardial infarction, target vessel revascularization, stroke, and major bleeding. : The prevalence rate of CKD was 48%. Patients with CKD were older and had higher prevalence of hypertension and diabetes mellitus than those without. Kaplan-Meier analysis revealed a significantly higher composite event rate in patients with CKD (log-rank test, = 0.003). In the multivariate Cox proportional hazards analysis, CKD was independently associated with composite events after adjusting for confounding factors (adjusted hazard ratio 1.985, 95% confidence intervals 1.157-3.406, = 0.013), mainly driven by all-cause deaths. : CKD was associated with unfavorable outcomes in CAD patients who underwent PCI with a DCB.

摘要

药物涂层球囊(DCB)是经皮冠状动脉介入治疗(PCI)中一种新兴的治疗技术。然而,DCB用于PCI的预后因素仍未完全明确。慢性肾脏病(CKD)是接受PCI的冠状动脉疾病(CAD)患者不良结局的独立预测因素。本研究的目的是阐明CKD对接受DCB-PCI的CAD患者预后的影响。

我们纳入了2015年至2023年期间连续252例接受DCB-PCI的CAD患者。本研究的终点是包括全因死亡、心肌梗死、靶血管血运重建、中风和大出血在内的复合事件。

CKD的患病率为48%。与无CKD的患者相比,CKD患者年龄更大,高血压和糖尿病的患病率更高。Kaplan-Meier分析显示,CKD患者的复合事件发生率显著更高(对数秩检验,P = 0.003)。在多变量Cox比例风险分析中,在校正混杂因素后,CKD与复合事件独立相关(调整后的风险比为1.985,95%置信区间为1.157 - 3.406,P = 0.013),主要由全因死亡驱动。

CKD与接受DCB-PCI的CAD患者的不良结局相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/911a/11989811/451cd2657d07/jcm-14-02317-g001.jpg

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