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Percutaneous coronary intervention strategies and prognosis for graft lesions following coronary artery bypass grafting

机译：冠状动脉搭桥术后经皮冠状动脉介入治疗策略及移植物病变预后

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The purpose of this study was to compare the prognosis of graft-percutaneous coronary intervention (PCI) and native vessel (NV)-PCI, drug-eluting stents (DESs) and bare-metal stents (BMSs) for the treatment of graft lesions following coronary artery bypass grafting (CABG), and to determine the risk factors for major adverse cardiac events (MACEs). A total of 289 patients who underwent PCI following CABG between August 2005 and March 2010 were retrospectively analyzed. The effects on survival were compared among patients who underwent NV- and graft-PCI, and DES and BMS implantation. Additionally, the risk factors for MACEs following PCI for graft lesions were analyzed. The findings showed that MACE-free and revascularization-free survival rates were significantly higher in the NV-PCI group compared with those in the graft-PCI group. There were 63 cases (29.0%) of MACEs in the DES group and 25 cases (52.1%) in the BMS group. In patients undergoing NV-PCI, the DES group had significantly fewer MACEs and less target vessel revascularization (TVR) than the BMS group. In patients undergoing graft-PCI, the DES group showed a tendency for fewer MACEs and a lower incidence of cardiac mortality, myocardial infarction and TVR compared with the BMS group. Diabetes, an age of >70 years and graft-PCI were independent risk factors for MACEs in patients post-PCI. It is concluded that NV-PCI has superior long-term outcomes compared with graft-PCI, and should therefore be considered as the first-line treatment for graft disease following CABG. Despite this, graft-PCI remains a viable option. DESs are the first choice for graft-PCI due to their safety and efficacy and their association with reduced mortality and MACE rate. Diabetes, older age and graft-PCI are independent risk factors for MACEs in patients post-CABG who are undergoing revascularization.
机译：这项研究的目的是比较移植物经皮冠状动脉介入治疗（PCI）和天然血管（NV）-PCI，药物洗脱支架（DES）和裸金属支架（BMS）在治疗移植后皮损后的预后冠状动脉搭桥术（CABG），并确定主要不良心脏事件（MACE）的危险因素。回顾性分析了2005年8月至2010年3月在CABG后行PCI的289例患者。比较了接受NV-和PCI-移植，DES和BMS植入的患者对生存的影响。此外，分析了PCI后移植物病变发生MACE的危险因素。研究结果表明，与移植PCI组相比，NV-PCI组的无MACE和无血运重建的生存率显着更高。 DES组有63例（29.0％）MACE，BMS组有25例（52.1％）。在接受NV-PCI的患者中，与BMS组相比，DES组的MACE和靶血管血运重建（TVR）明显减少。与BMS组相比，DES组显示出发生PCI-PCI的趋势是MACE减少，心脏死亡率，心肌梗塞和TVR发生率降低。年龄大于70岁的糖尿病和PCI移植是PCI后患者发生MACE的独立危险因素。结论是，与移植PCI相比，NV-PCI具有更好的长期疗效，因此应被视为CABG术后移植物疾病的一线治疗。尽管如此，嫁接PCI仍然是可行的选择。 DES由于其安全性和有效性以及与降低的死亡率和MACE率的关系而成为移植PCI的首选。在行血运重建的CABG患者中，糖尿病，老年和移植PCI是发生MACE的独立危险因素。

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