药物支架与冠状动脉搭桥手术治疗冠心病多支病变疗效对比课件.pptVIP

药物支架与冠状动脉搭桥手术治疗冠心病多支病变疗效对比 观察终点: 早期: 院内 / 30天 死亡； 远期: 死亡； 心梗； 靶血管再血管化。 统计分析 : 观察性研究存在： * 选择性偏移 * 潜在的混杂因素的影响 统计学调整： * 住院及30天死亡率：Stepwise logistic regression model * 远期随访结果：Stepwise Cox proportional hazards models * 倾向性积分 搭桥组, n=1886 896 例(47.5%) 行OPCAB 1850 例(98.1%) 接受至少1根乳内动脉桥 平均搭桥支数: 2.86 平均末梢吻合个数: 4.28 药物支架治疗组, n=1834 当个患者平均支架植入枚数： 2.68±0.95 (2.25±1.25 DES and 0.43±0.72 BMS). 平均支架直径 3.05±0.46mm. 两联抗血小板治疗: 阿司匹林 + 波力维 住院/30天死亡率的risk-adjusted rate无明显差别 Adjusted OR, 0.779; 95% CI, 0.514 to 1.186; P = 0.269 我们的主要发现 CABG组有较低的死亡率，心梗发生率及靶血管再血管化率 四个亚组（糖尿病，年龄大于70岁，3支病变，2支病变）的数据分析提示CABG有更好远期安全性及有效性。 冠心病多支病变的再血管化: DES vs. Bypass 仍存争议！ Comparison of Drug-Eluting Stents and Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Disease End points: Early: In-hospital / 30-day death; Long-term: Death; MI; target-vessel revascularization (TVR) during follow-up. Statistical Analysis : Observational study * Treatment-selection bias * Potential confounding variables Robust adjustment was performed * Stepwise logistic regression model for in- hospital / 30-day mortality * Stepwise Cox proportional hazards models for long-term outcomes. * Propensity analysis 2-tailed, and a significant level of 0.05 SPSS version 13.0 and MATLAB 6.1 CABG group, n=1886 896 patients (47.5%) underwent OPCAB 1850 patients (98.1%) received at least one ITA The mean number of bypass grafts per patient: 2.86 The mean number of distal anastomoses per patient: 4.28 Drug-eluting stents group, n=1834 The mean total number of stents implanted in