JACC:使用药物洗脱支架患者死亡风险低

2012-01-20 MedSci MedSci原创

一项发表于《美国心脏学会杂志》J Am Coll Cardiol杂志上的研究论文"Percutaneous coronary intervention and drug-eluting stent use among patients ≥85 years of age in the United States"证实:在直接经皮冠状动脉介入治疗中,虽然使用药物洗脱支架和裸金属支架的老年病人数显著下降

一项发表于《美国心脏学会杂志》J Am Coll Cardiol杂志上的研究论文"Percutaneous coronary intervention and drug-eluting stent use among patients ≥85 years of age in the United States"证实:在直接经皮冠状动脉介入治疗中,虽然使用药物洗脱支架和裸金属支架的老年病人数显著下降,但是使用药物洗脱支架的患者发生不良反应的几率要比使用裸金属支架的患者低。 杜克大学的医学博士Tracy Y. Yang和她的同事发现:与使用裸金属支架相比,使用药物洗脱支架的八十五岁及以上老年患者具有更低的校正死亡率(29%对38%,校正风险率=0.80,95%置信区间0.77对0.83)。然而,随着年龄的增长,调整后的死亡率差异也不断缩小 (P<0.001)。 虽然美国的老龄化问题愈发严重,但是只有少量的研究比较了使用药物洗脱支架与裸金属支架在八十五岁及以上老年患者中的成效。这也导致了在这一人群中风险和利益平衡的不确定性,研究人员们希望能解决这个问题。 作者评估了从美国最大的直接经皮

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    2012-06-05 hbwxf
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NEJM:药物洗脱支架PCI 或冠脉旁路移植术(CABG)后的生活质量比较

MedSci评论:临床采用CABG,以及药物洗脱支架(DES)用于PCI,已很普通,但是本文选择的角度很特别,这也就是创新性:(1)多血管病变!(2)CABG与DES支架PCI进行对比;(3)随机对照;(4)大样本;(5)有12个月的随访评价;(6)评价的标准为SAQ,SF-36。当然,如果有必要的话,还可以采用3.0 MRI进行终点评价,从影像学角度进一步证实,这样会更有说服力(不过用MRI作为