基于倾向性匹配评分的左主干病变预先置入IABP对比保守策略1年随访研究

关晓楠, 张建军, 杨曦艳, 等. 基于倾向性匹配评分的左主干病变预先置入IABP对比保守策略1年随访研究[J]. 临床心血管病杂志, 2020, 36(9): 827-830. doi: 10.13201/j.issn.1001-1439.2020.09.011
引用本文: 关晓楠, 张建军, 杨曦艳, 等. 基于倾向性匹配评分的左主干病变预先置入IABP对比保守策略1年随访研究[J]. 临床心血管病杂志, 2020, 36(9): 827-830. doi: 10.13201/j.issn.1001-1439.2020.09.011
GUAN Xiaonan, ZHANG Jianjun, YANG Xiyan, et al. A propensity score matched analysis for one year follow-up of IABP in left main artery disease compared with conservative strategy[J]. J Clin Cardiol, 2020, 36(9): 827-830. doi: 10.13201/j.issn.1001-1439.2020.09.011
Citation: GUAN Xiaonan, ZHANG Jianjun, YANG Xiyan, et al. A propensity score matched analysis for one year follow-up of IABP in left main artery disease compared with conservative strategy[J]. J Clin Cardiol, 2020, 36(9): 827-830. doi: 10.13201/j.issn.1001-1439.2020.09.011

基于倾向性匹配评分的左主干病变预先置入IABP对比保守策略1年随访研究

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    通讯作者: 张建军,E-mail:zmn0359@vip.sina.com
  • 中图分类号: R541.4

A propensity score matched analysis for one year follow-up of IABP in left main artery disease compared with conservative strategy

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  • 目的:分析在左主干介入治疗中预先置入主动脉球囊反搏(IABP)对比保守策略的效果与安全性差异。方法:纳入2013年1月-2018年9月在北京朝阳医院行左主干介入治疗患者共237例。其中预先置入患者127例(预先置入组),未置入IABP110例(保守策略组)。观察两组患者术后1个月内主要心脏不良事件(MACE)、术后1年病死率、再次血运重建、再发心血管不良事件。结果:经倾向性匹配评分后,①预先置入组术后1个月内的MACE显著低于保守策略组(9.6%∶21.7%,P=0.033)。多因素Logistics回归分析表明双支架术式是MACE的独立危险因素(OR 3.026,95%CI:1.173~7.808,P=0.022);预先置入IABP是MACE的独立保护因素(OR 0.359,95%CI:0.143~0.900,P=0.029)。②两组患者1年MACE差异无统计学意义。③两组患者1年病死率的Kaplan-Meier曲线未见显著差异(log-rank P=0.665)。结论:在左主干病变的介入治疗中,预先置入IABP可减少术后1个月内的MACE的发生率,但不能降低远期病死率。
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  • [1]

    Prondzinsky R,Unverzagt S,Russ M,et al.Hemodynamic effects of intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock:the prospective,randomized IABP shock trial[J].Shock,2012,37(4):378-384.

    [2]

    Rios SA,Bravo CA,Weinreich M,et al.Meta-analysis and trial sequential analysis comparing percutaneous ventricular assist devices versus intra-aortic balloon pump during high-risk percutaneous coronary intervention or cardiogenic shock[J].Am J Cardiol,2018,122(8):1330-1338.

    [3]

    罗明华,关怀敏,解金红,等.体外膜肺氧合联合主动脉球囊反搏支持下经皮冠状动脉介入救治高危冠心病10例总结[J].临床心血管病杂志,2019,35(7):620-624.

    [4]

    赵昕,韩雅玲,王守力,等.主动脉内球囊反搏术辅助治疗急性心肌梗死合并左主干病变患者的疗效分析[J].中华医学杂志,2012,92(38):2685-2688.

    [5]

    Unverzagt S,Buerke M,de Waha A,et al.Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock[J].Cochrane Database Syst Rev,2015,(3):CD007398.

    [6]

    Thiele H,Zeymer U,Neumann FJ,et al.Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II):final 12 month results of a randomised,open-label trial[J].Lancet,2013,382(9905):1638-1645.

    [7]

    Thygesen K,Alpert JS,Jaffe AS,et al.Fourth universal definition of myocardial infarction (2018)[J].Circulation,2018,138(20):e618-e651.

    [8]

    Mohr FW,Morice MC,Kappetein AP,et al.Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease:5-year follow-up of the randomised,clinical SYNTAX trial[J].Lancet,2013,381(9867):629-638.

    [9]

    王东方,刘智慧,王宇楠,等.IABP联合PCI治疗STEMI合并心源性休克的多因素回顾性分析[J].临床心血管病杂志,2019,35(12):1124-1127.

    [10]

    Stone GW,Marsalese D,Brodie BR,et al.A prospective,randomized evaluation of prophylactic intraaortic balloon counterpulsation in high risk patients with acute myocardial infarction treated with primary angioplasty.Second Primary Angioplasty in Myocardial Infarction (PAMI-II) Trial Investigators[J].J Am Coll Cardiol,1997,29(7):1459-1467.

    [11]

    Romeo F,Acconcia MC,Sergi D,et al.Lack of intra-aortic balloon pump effectiveness in high-risk percutaneous coronary interventions without cardiogenic shock:a comprehensive meta-analysis of randomised trials and observational studies[J].Int J Cardiol,2013,167(5):1783-1793.

    [12]

    Perera D,Stables R,Clayton T,et al.Long-term mortality data from the balloon pump-assisted coronary intervention study (BCIS-1):a randomized,controlled trial of elective balloon counterpulsation during high-risk percutaneous coronary intervention[J].Circulation,2013,127(2):207-212.

    [13]

    Lee JM,Park J,Kang J,et al.The efficacy and safety of mechanical hemodynamic support in patients undergoing high-risk percutaneous coronary intervention with or without cardiogenic shock:Bayesian approach network meta-analysis of 13 randomized controlled trials[J].Int J Cardiol,2015,184:36-46.

    [14]

    Neumann FJ,Sousa-Uva M,Ahlsson A,et al.2018 ESC/EACTS Guidelines on myocardial revascularization[J].Euro Heart J,2019,40(2):87-165.

    [15]

    刘世栋,宋钰萌,李昕,等.单支架与双支架技术治疗无保护左主干临床疗效的Meta分析[J].临床心血管病杂志,2019,35(9):842-847.

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出版历程
收稿日期:  2020-05-12

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