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首页> 外文期刊>The American Journal of Cardiology >Comparison of Outcomes of Percutaneous Coronary Intervention on Native Coronary Arteries Versus on Saphenous Venous Aorta Coronary Conduits in Patients With Low Left Ventricular Ejection Fraction and Impella Device Implantation Achieved or Attempted (from the PROTECT II Randomized Trial and the cVAD Registry)
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Comparison of Outcomes of Percutaneous Coronary Intervention on Native Coronary Arteries Versus on Saphenous Venous Aorta Coronary Conduits in Patients With Low Left Ventricular Ejection Fraction and Impella Device Implantation Achieved or Attempted (from the PROTECT II Randomized Trial and the cVAD Registry)

机译：低左心室喷射分数患者对天然冠状动脉患者对天皮冠状动脉冠状动脉冠状动脉的比较，达到左心室喷射分数和偶像装置植入（从保护II随机试验和CVAD注册表）

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Patients with prior coronary artery bypass grafting (CABG) represent a high-risk cohort given associated medical conditions and worse outcome of saphenous vein graft compared with native vessel percutaneous coronary intervention (PCI). The goal of the current analysis was to compare clinical outcomes in 591 patients with and without prior CABG and multivessel coronary artery disease or unprotected left main disease and severely reduced left ventricular systolic function underwent Impella supported PCI from the PROTECT II randomized trial and the cVAD Registry. Patients with prior CABG surgery (n?=?201) were compared with those without prior CABG surgery (n?=?390). The primary end point of this analysis was overall mortality at 30 days. Patients with prior CABG surgery had greater Society of Thoracic Surgery mortality score compared with patients without prior CABG surgery, 7.6 ± 6.4 versus 5.1 ± 5.5, respectively, p <0.001. Saphenous vein graft PCI was performed in 17% of patients with prior CABG surgery. Number of vessels treated was lower in patients with prior CABG surgery compared with patients without prior CABG surgery, 1.66 ± 0.56 versus 1.89 ± 0.64, respectively, p <0.001. Achievement of TIMI 3 flow post PCI and overall PCI success was similar in the twogroups. Overall mortality at 30 days was similar in patients with prior CABG surgery compared with patients without prior CABG surgery, 6.75% versus 6.61%, respectively, p?=?1.0. In conclusion, in this high-risk cohort of patients underwent hemodynamically supported PCI, prior CABG surgery was not associated with worse outcome. The use of hemodynamic support appears to mitigate the increased risk of PCI associated with prior CABG.
机译：先前冠状动脉旁路接枝（CABG）的患者代表了赋予相关的医疗条件的高风险队列，以及与天真冠状动脉介入（PCI）的天皮血管相比，隐静脉移植的较差的结果。目前分析的目的是比较591例患有现有CABG和多型冠状动脉疾病的临床结果或未受到保护的左主要疾病，并且严重减少左心室收缩功能接受了VILBLA支持的PCI，从保护II随机试验和CVAD注册表。将患有先前CABG手术的患者（n？=Δ2）与没有先前CABG手术的人进行比较（n？= 390）。该分析的主要终点是30天的总体死亡率。与未发表CABG手术的患者相比，现有CABG手术的患者具有更大的胸外科死亡率，分别为7.6±6.4，P <0.001分别为5.1±5.5。隐静脉移植PCI以17％的先前CABG手术患者进行。与未成本CABG手术的患者相比，患者治疗的血管数量较低，分别为1.66±0.56与1.89±0.64，P <0.001分别为1.89±0.56。在双组中，PCI和整体PCI成功的成就在PCI和整体PCI成功中相似。早期CABG手术患者的整体死亡率与未经前期CABG手术的患者相比，6.75％，分别为6.61％，P？= 1.0。总之，在这种高风险的患者的患者中，经过血流动力学支持的PCI，之前的CABG手术与更差的结果无关。血液动力学支持的使用似乎减轻了与先前CABG相关的PCI的风险增加。

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