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摘要: 介入治疗是目前治疗冠心病的重要方法之一。在过去的20年中，冠心病介入治疗研究百花齐放，取得了丰硕的研究成果，尤其是在策略、抗栓药物、新一代支架、药物球囊、功能学及腔内影像、钙化处理、左心辅助器械方面。该文就近年冠心病介入治疗最新进展进行梳理，以期为冠心病介入治疗的临床实践提供帮助。Abstract: Interventional therapy is currently one of the important methods for treating coronary heart disease. In the past 20 years, there have been numerous studies on interventional therapy for coronary heart disease, and fruitful research results have been achieved, especially in the areas of strategy, antithrombotic drugs, new generation stents, drug balloons, functional and intracavitary imaging, calcification treatment, and left ventricular assist devices. This article reviews the latest developments in interventional therapy for coronary heart disease, in order to provide assistance for clinical practice of interventional therapy in coronary heart disease.
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Key words:
- coronary heart disease /
- interventional therapy /
- progress
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[1] Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2022, 145(3): e18-e114.
[2] Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes[J]. Eur Heart J, 2023, 44(38): 3720-3826. doi: 10.1093/eurheartj/ehad191
[3] Sardella G, Lucisano L, Garbo R, et al. Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients: The SMILE Trial[J]. J Am Coll Cardiol, 2016, 67(3): 264-272. doi: 10.1016/j.jacc.2015.10.082
[4] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 非ST段抬高型急性冠脉综合征诊断和治疗指南(2024)[J]. 中华心血管病杂志, 2024, 52(6): 615-646. doi: 10.3760/cma.j.cn112148-20240107-00014
[5] Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease[J]. N Engl J Med, 2020, 382(15): 1395-1407. doi: 10.1056/NEJMoa1915922
[6] Hochman JS, Anthopolos R, Reynolds HR, et al. Survival After Invasive or Conservative Management of Stable Coronary Disease[J]. Circulation, 2023, 147(1): 8-19. doi: 10.1161/CIRCULATIONAHA.122.062714
[7] Mc Ardle B, Shukla T, Nichol G, et al. Long-Term Follow-Up of Outcomes With F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients With Severe Left Ventricular Dysfunction Secondary to Coronary Disease[J]. Circ Cardiovasc Imaging, 2016, 9(9): e004331. doi: 10.1161/CIRCIMAGING.115.004331
[8] Sun LY, Gaudino M, Chen RJ, et al. Long-term Outcomes in Patients With Severely Reduced Left Ventricular Ejection Fraction Undergoing Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting[J]. JAMA Cardiol, 2020, 5(6): 631-641. doi: 10.1001/jamacardio.2020.0239
[9] Bloom JE, Vogrin S, Reid CM, et al. Coronary artery bypass grafting vs. percutaneous coronary intervention in severe ischaemic cardiomyopathy: long-term survival[J]. Eur Heart J, 2025, 46(1): 72-80. doi: 10.1093/eurheartj/ehae672
[10] Sabatine MS, Bergmark BA, Murphy SA, et al. Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis[J]. Lancet, 2021, 398(10318): 2247-2257. doi: 10.1016/S0140-6736(21)02334-5
[11] Zimmermann FM, Ding VY, Pijls NHJ, et al. Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial[J]. Circulation, 2023, 148(12): 950-958. doi: 10.1161/CIRCULATIONAHA.123.065770
[12] Lowenstern A, Wu J, Bradley SM, et al. Current landscape of hybrid revascularization: A report from the NCDR CathPCI Registry[J]. Am Heart J, 2019, 215, 167-177. doi: 10.1016/j.ahj.2019.06.014
[13] Ganyukov VI, Kochergin NA, Shilov AA, et al. Randomized Clinical Trial of Surgical Versus Percutaneous Versus Hybrid Multivessel Coronary Revascularization: 3 Years' Follow-Up[J]. JACC Cardiovasc Interv, 2021, 14(10): 1163-1165. doi: 10.1016/j.jcin.2021.02.037
[14] Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes[J]. N Engl J Med, 2009, 361(11): 1045-1057. doi: 10.1056/NEJMoa0904327
[15] Ge Z, Kan J, Gao X, et al. Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes(ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial[J]. Lancet, 2024, 403(10439): 1866-1878. doi: 10.1016/S0140-6736(24)00473-2
[16] Mehran R, Baber U, Sharma SK, et al. Ticagrelor with or without Aspirin in High-Risk Patients after PCI[J]. N Engl J Med, 2019, 381(21): 2032-2042. doi: 10.1056/NEJMoa1908419
[17] Brophy JM, Belisle P, Joseph L. Evidence for use of coronary stents. A hierarchical bayesian meta-analysis[J]. Ann Intern Med, 2003, 138(10): 777-786. doi: 10.7326/0003-4819-138-10-200305200-00005
[18] Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization[J]. N Engl J Med, 2002, 346(23): 1773-1780. doi: 10.1056/NEJMoa012843
[19] Cassese S, Byrne RA, Ndrepepa G, et al. Everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a meta-analysis of randomised controlled trials[J]. Lancet, 2016, 387(10018): 537-544. doi: 10.1016/S0140-6736(15)00979-4
[20] Erlinge D, Andersson J, Fröbert O, et al. Bioadaptor implant versus contemporary drug-eluting stent in percutaneous coronary interventions in Sweden(INFINITY-SWEDEHEART): a single-blind, non-inferiority, registry-based, randomised controlled trial[J]. Lancet, 2024, 404(10464): 1750-1759. doi: 10.1016/S0140-6736(24)02227-X
[21] Latib A, Colombo A, Castriota F, et al. A randomized multicenter study comparing a paclitaxel drug-eluting balloon with a paclitaxel-eluting stent in small coronary vessels: the BELLO(Balloon Elution and Late Loss Optimization)study[J]. J Am Coll Cardiol, 2012, 60(24): 2473-2480. doi: 10.1016/j.jacc.2012.09.020
[22] Jing QM, Zhao X, Han YL, et al. A drug-eluting balloon for the treatment of coronary bifurcation lesions in the side branch: a prospective multicenter randomized(BEYOND)clinical trial in China[J]. Chin Med J(Engl), 2020, 133(8): 899-908.
[23] Gao X, Tian N, Kan J, et al. Drug-Coated Balloon Angioplasty of the Side Branch During Provisional Stenting: The Multicenter Randomized DCB-BIF Trial[J]. J Am Coll Cardiol, 2025, 85(1): 1-15. doi: 10.1016/j.jacc.2024.08.067
[24] Cortese B, Testa G, Rivero F, et al. Long-Term Outcome of Drug-Coated Balloon vs Drug-Eluting Stent for Small Coronary Vessels: PICCOLETO-II 3-Year Follow-Up[J]. JACC Cardiovasc Interv, 2023, 16(9): 1054-1061. doi: 10.1016/j.jcin.2023.02.011
[25] Gao C, He XQ, Ouyang F, et al. Drug-coated balloon angioplasty with rescue stenting versus intended stenting for the treatment of patients with de novo coronary artery lesions(REC-CAGEFREE I): an open-label, randomised, non-inferiority trial[J]. Lancet, 2024, 404(10457): 1040-1050. doi: 10.1016/S0140-6736(24)01594-0
[26] van Nunen LX, Zimmermann FM, Tonino PA, et al. Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease(FAME): 5-year follow-up of a randomised controlled trial[J]. Lancet, 2015, 386(10006): 1853-1860. doi: 10.1016/S0140-6736(15)00057-4
[27] Fearon WF, Zimmermann FM, De Bruyne B, et al. Fractional Flow Reserve-Guided PCI as Compared with Coronary Bypass Surgery[J]. N Engl J Med, 2022, 386(2): 128-137. doi: 10.1056/NEJMoa2112299
[28] Layland J, Oldroyd KG, Curzen N, et al. Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial[J]. Eur Heart J, 2015, 36(2): 100-111. doi: 10.1093/eurheartj/ehu338
[29] Eftekhari A, Holck EN, Westra J, et al. Instantaneous wave free ratio vs. fractional flow reserve and 5-year mortality: iFR SWEDEHEART and DEFINE FLAIR[J]. Eur Heart J, 2023, 44(41): 4376-4384. doi: 10.1093/eurheartj/ehad582
[30] Berntorp K, Rylance R, Yndigegn T, et al. Clinical Outcome of Revascularization Deferral With Instantaneous Wave-Free Ratio and Fractional Flow Reserve: A 5-Year Follow-Up Substudy From the iFR-SWEDEHEART Trial[J]. J Am Heart Assoc, 2023, 12(3): e028423. doi: 10.1161/JAHA.122.028423
[31] Song L, Xu B, Tu S, et al. 2-Year Outcomes of Angiographic Quantitative Flow Ratio-Guided Coronary Interventions[J]. J Am Coll Cardiol, 2022, 80(22): 2089-2101. doi: 10.1016/j.jacc.2022.09.007
[32] Yang J, Shan D, Wang X, et al. On-Site Computed Tomography-Derived Fractional Flow Reserve to Guide Management of Patients With Stable Coronary Artery Disease: The TARGET Randomized Trial[J]. Circulation, 2023, 147(18): 1369-1381. doi: 10.1161/CIRCULATIONAHA.123.063996
[33] Lee JM, Choi KH, Song YB, et al. Intravascular Imaging-Guided or Angiography-Guided Complex PCI[J]. N Engl J Med, 2023, 388(18): 1668-1679. doi: 10.1056/NEJMoa2216607
[34] Holm NR, Andreasen LN, Neghabat O, et al. OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions[J]. N Engl J Med, 2023, 389(16): 1477-1487. doi: 10.1056/NEJMoa2307770
[35] Ali ZA, Landmesser U, Maehara A, et al. Optical Coherence Tomography-Guided versus Angiography-Guided PCI[J]. N Engl J Med, 2023, 389(16): 1466-1476. doi: 10.1056/NEJMoa2305861
[36] Li X, Ge Z, Kan J, et al. Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes(IVUS-ACS): a two-stage, multicentre, randomised trial[J]. Lancet, 2024, 403(10439): 1855-1865. doi: 10.1016/S0140-6736(24)00282-4
[37] Angsubhakorn N, Kang N, Fearon C, et al. Contemporary Management of Severely Calcified Coronary Lesions[J]. J Pers Med, 2022, 12(10): 1638. doi: 10.3390/jpm12101638
[38] Lee T, Shlofmitz RA, Song L, et al. The effectiveness of excimer laser angioplasty to treat coronary in-stent restenosis with peri-stent calcium as assessed by optical coherence tomography[J]. EuroIntervention, 2019, 15(3): e279-e288. doi: 10.4244/EIJ-D-18-00139
[39] Rawlins J, Din JN, Talwar S, et al. Coronary Intervention with the Excimer Laser: Review of the Technology and Outcome Data[J]. Interv Cardiol, 2016, 11(1): 27-32. doi: 10.15420/icr.2016:2:2
[40] Redfors B, Sharma SK, Saito S, et al. Novel Micro Crown Orbital Atherectomy for Severe Lesion Calcification: Coronary Orbital Atherectomy System Study(COAST)[J]. Circ Cardiovasc Interv, 2020, 13(8): e008993. doi: 10.1161/CIRCINTERVENTIONS.120.008993
[41] Généreux P, Kirtane AJ, Kandzari DE, et al. Randomized evaluation of vessel preparation with orbital atherectomy prior to drug-eluting stent implantation in severely calcified coronary artery lesions: Design and rationale of the ECLIPSE trial[J]. Am Heart J, 2022, 249: 1-11. doi: 10.1016/j.ahj.2022.03.003
[42] Karimi Galougahi K, Patel S, Shlofmitz RA, et al. Calcific Plaque Modification by Acoustic Shock Waves: Intravascular Lithotripsy in Coronary Interventions[J]. Circ Cardiovasc Interv, 2021, 14(1): e009354. doi: 10.1161/CIRCINTERVENTIONS.120.009354
[43] 中国医师协会心力衰竭专业委员会, 国家心血管病专家委员会心力衰竭专业委员会, 中华心力衰竭和心肌病杂志编辑委员会. 经皮机械循环辅助临床应用及管理中国专家共识[J]. 中华心力衰竭和心肌病杂志, 2020, 4(3): 145-158. doi: 10.3760/cma.j.cn101460-20200812-00078
[44] Henry TD, Tomey MI, Tamis-Holland JE, et al. Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement From the American Heart Association[J]. Circulation, 2021, 143(15): e815-e829.
[45] Helgestad OKL, Josiassen J, Hassager C, et al. Contemporary trends in use of mechanical circulatory support in patients with acute MI and cardiogenic shock[J]. Open Heart, 2020, 7(1): e001214. doi: 10.1136/openhrt-2019-001214
[46] Schrage B, Ibrahim K, Loehn T, et al. Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock[J]. Circulation, 2019, 139(10): 1249-1258. doi: 10.1161/CIRCULATIONAHA.118.036614
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