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首页> 外文期刊>Catheterization and cardiovascular interventions: Official journal of the Society for Cardiac Angiography & Interventions >Incidence, procedural management, and clinical outcomes of coronary in‐stent restenosis: Insights from the National VA CART Program
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Incidence, procedural management, and clinical outcomes of coronary in‐stent restenosis: Insights from the National VA CART Program

机译：冠状动脉内切狭窄的发病率，程序管理和临床结果：来自国家VA购物车计划的见解

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Abstract Backround In‐stent restenosis (ISR) remains a common clinical problem associated with significant morbidity. We sought to evaluate the temporal trends in incidence and procedural management of coronary restenosis as well as evaluate the association between different treatment modalities and clinical outcomes. Methods We identified all patients treated for coronary ISR within the Veterans Affairs Healthcare System from October 1, 2006 to September 30, 2014. The temporal trends in incidence as well as intraprocedural management were assessed. Among patients treated for single vessel restenosis, a propensity matched cohort was created for those treated with drug‐eluting stents (DES) or other treatment modalities. Target vessel revascularization (TVR) and mortality were compared between the two subpopulations. Results From 2006 to 2014, 65,443 patients underwent percutaneous coronary intervention and 6,872 patients (10.5%) with 8,921 lesions were treated for ISR. The proportion of patients undergoing revascularization for restenosis increased 0.28% per year ( P ?=?0.055). Among a propensity‐matched cohort of 6,231, the rates of TVR (subdistribution HR: 0.623, 95% CI: 0.511–0.760) and mortality (HR: 0.730, 95% CI: 0.641–0.830) were significantly lower among patients treated with a DES compared with other treatments. After adjustment for known risk factors, treatment with DES continued to be associated with a reduction in mortality rate (Adjusted HR: 0.802, 95% CI: 0.704–0.913). Conclusions There is a trend toward an increasing proportion of coronary interventions for ISR in a national cohort of Veterans and treatment with a DES is associated with the lowest rate of TVR and overall mortality.
机译：摘要后支架再狭窄（ISR）仍然是与显着发病率相关的常见临床问题。我们试图评估冠状动脉再狭窄的发病率和程序管理的时间趋势，以及评估不同治疗方式与临床结果之间的关联。方法鉴定了2006年10月1日至2014年9月30日从退伍军人事务医疗保健系统内治疗冠状动脉ISR的患者。评估发病率和颅内管理的时间趋势。在为单血管再狭窄治疗的患者中，为用药物洗脱支架（DES）或其他治疗方式处理的那些产生倾向匹配的队列。在两种亚群之间比较了目标血管血运重建（TVR）和死亡率。结果2006年至2014年，65,443名患者经过经皮冠状动脉干预和6,872名患者（10.5％），为ISR处理了8,921例病变。接受血运重建的患者的比例每年增加0.28％（P？= 0.055）。在6,231次匹配的群组中，TVR的速率（分区HR：0.623,95％CI：0.511-0.760）和死亡率（HR：0.730,95％CI：0.641-0.830）在用A治疗的患者显着降低与其他治疗相比。在调整已知风险因素后，使用DES的治疗继续与死亡率降低相关（调整后的HR：0.802,95％CI：0.704-0.913）。结论在国民队列的退伍军人队列中冠状动脉干预越来越大的冠状动脉干预趋势，与DES的治疗与TVR的最低速度和总体死亡率有关。

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