...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American Journal of Cardiology >Five-Year Outcomes of Percutaneous Versus Surgical Coronary Revascularization in Patients With Diabetes Mellitus (from the CREDO-Kyoto PCI/CABG Registry Cohort-2)
【24h】

Five-Year Outcomes of Percutaneous Versus Surgical Coronary Revascularization in Patients With Diabetes Mellitus (from the CREDO-Kyoto PCI/CABG Registry Cohort-2)

机译：糖尿病患者经皮与冠状动脉血运重建的五年结果（来自CREDO-Kyoto PCI / CABG注册组2）

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

We investigated the impact of diabetes mellitus on long-term outcomes of percutaneous coronary intervention (PCI) in the drug-eluting stent era versus coronary artery bypass grafting (CABG) in a real-world population with advanced coronary disease. We identified 3,982 patients with 3-vessel and/or left main disease of 15,939 patients with first coronary revascularization enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 (patients without diabetes: n = 1,984 [PCI: n = 1,123 and CABG: n = 861], and patients with diabetes: n = 1,998 [PCI: n = 1,065 and CABG: n = 933]). Cumulative 5-year incidence of all-cause death after PCI was significantly higher than after CABG both in patients without and with diabetes (19.8% vs 16.2%, p = 0.01, and 22.9% vs 19.0%, p = 0.046, respectively). After adjusting confounders, the excess mortality risk of PCI relative to CABG was no longer significant (hazard ratio [HR] 1.16; 95% confidence interval [CI] 0.88 to 1.54; p = 0.29) in patients without diabetes, whereas it remained significant (HR 1.31; 95% CI 1.01 to 1.70; p = 0.04) in patients with diabetes. The excess adjusted risks of PCI relative to CABG for cardiac death, myocardial infarction (MI), and any coronary revascularization were significant in both patients without (BR 1.59, 95% CI 1.01 to 2.51, p = 0.047; HR 2.16, 95% CI 1.20 to 3.87, p = 0.01; and HR 3.30, 95% CI 2.55 to 4.25, p < 0.001, respectively) and with diabetes (HR 1.45, 95% CI 1.00 to 2.51, p = 0.047; HR 2.31, 95% CI 1.31 to 4.08, p = 0.004; and BR 3.70, 95% CI 2.91 to 4.69, p < 0.001, respectively). There was no interaction between diabetic status and the effect of PCI relative to CABG for all-cause death, cardiac death, MI, and any revascularization. In conclusion, in both patients without and with diabetes with 3-vessel and/or left main disease, CABG compared with PCI was associated with better 5-year outcomes in terms of cardiac death, MI, and any coronary revascularization. There was no difference in the direction and magnitude of treatment effect of CABG relative to PCI regardless of diabetic status. (C) 2015 Elsevier Inc. All rights reserved.
机译：我们研究了在现实的冠心病晚期人群中，药物洗脱支架时代与冠状动脉旁路移植术（CABG）相比，糖尿病对经皮冠状动脉介入治疗（PCI）长期效果的影响。我们在京都PCI / CABG注册研究队列2中确定了3,982例3支血管和/或左主干疾病的15,939例首次进行冠状动脉血运重建的患者，证实了结果研究（无糖尿病患者：n = 1,984 [PCI：n = 1,123，CABG：n = 861]，糖尿病患者：n = 1,998 [PCI：n = 1,065，CABG：n = 933]）。无论有无糖尿病患者，PCI术后5年全因死亡累计发生率均显着高于CABG后（分别为19.8％vs 16.2％，p = 0.01，22.9％vs 19.0％，p = 0.046）。调整混杂因素后，在没有糖尿病的患者中，PCI相对于CABG的额外死亡风险不再显着（危险比[HR] 1.16; 95％置信区间[CI] 0.88至1.54; p = 0.29）。糖尿病患者的HR为1.31; 95％CI为1.01至1.70; p = 0.04）。相对于CABG，PCI相对于CABG的心脏死亡，心肌梗塞（MI）和任何冠状动脉血运重建的过高调整风险在两个患者中均无统计学意义（BR 1.59，95％CI 1.01至2.51，p = 0.047; HR 2.16，95％CI 1.20至3.87，p = 0.01; HR 3.30，95％CI 2.55至4.25，p <0.001）和糖尿病（HR 1.45，95％CI 1.00至2.51，p = 0.047; HR 2.31，95％CI 1.31至4.08，p = 0.004; BR 3.70，95％CI 2.91至4.69，p <0.001）。糖尿病状态与PCI相对于CABG的全因死亡，心源性死亡，MI和任何血运重建之间的作用之间没有相互作用。总之，在患有和患有3支血管和/或左主干疾病的糖尿病患者中，CABG与PCI相比，在心源性死亡，MI和任何冠状动脉血运重建方面，其5年预后更好。相对于PCI，CABG相对于PCI的治疗方向和幅度没有差异。 （C）2015 Elsevier Inc.保留所有权利。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号