A single center investigation of bare-metal or drug-eluting stent restenosis from 1633 consecutive C

来源 :Chinese Medical Journal | 被引量 : 0次 | 上传用户:destinyjack1983
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Background Stents are widely used in China but the clinical impression is somehow that restenosis is less common because of the lower prevalence of coronary artery disease (CAD) and associated risk factors in Chinese populations. However, no large-sample published studies are available on angiographic stent restenosis including those of bare-metal stent (BMS) or drug-eluting stent (DES) in Chinese Han ethnic population. Mothods A total of 1633 consecutive patients with CAD who had undergone coronary stenting, quantitative coronary angiography (QCA) were retrospectively studied. At the time of stent implantation and at 7 months post-stenting 675 patients had a follow-up angiography. Statistical analysis was made with the chi-square test for categorical variables, unpaired t test for continuous variables, univariate or multivariate regression for baseline and angiographic characteristics and the Kaplan-Meier method for rate of target lesion revascularization (TLR). Results Stent restenosis was defined as ≥50% diameter stenosis in the dilated segment. A total of 675 patients with 1074 lesions were subjected to angiographic follow-up for 7 months on average. Of these lesions, 448 were implanted with BMS whereas 626 lesions with DES. At 7 months, bare-metal in-stent restenosis occured in 148 lesions (33.0%), and bare metal in-segment restenosis in 155 lesions (34.6%) in contrast to drug-eluting in-stent restenosis in 48 lesions (7.7%) and drug-eluting in-segment restenosis in 73 lesions (11.7%) (P<0.001 compared with BMS respectively). Late loss in both in-stent and in segment was higher in BMS than in DES groups [(1.00±0.69) vs (0.28±0.52); (0.78±0.71) vs (0.21±0.52), P<0.001 respectively]. Angulated lesion, lesion length, pre-procedural minimal luminal diameter (MLD), and BMS were independent predictors for TLR, (P<0.01 respectively), whereas current smoker, ostial lesion, and stent overlapping, post-procedure in-stent MLD, lesion length, and stent types were independent predictors for in-segment restenosis (P<0.01 respectively). Standard coronary risk factors such as hypertension, hyperlipidemia, diabetes, and history of CAD were not associated with a higher rate of restenosis caused by BMS or DES implantation in our Chinese Han ethnic population. Conclusions Coronary stenting including BMS or DES implantation in Chinese Han ethnic patients is associated with a restenosis rate comparable to that demonstrated in previous studies from the western countries, and predictors of stent restenosis are somehow different from those in the western population. Background Stents are widely used in China but the clinical impression is somehow that restenosis is less common because of the lower prevalence of coronary artery disease (CAD) and associated risk factors in Chinese populations. However, no large-sample published studies are available on angiographic Stent restenosis including those of bare-metal stent (BMS) or drug-eluting stent (DES) in Chinese Han ethnic population. Mothods A total of 1633 consecutive patients with CAD who had undergone coronary stenting, quantitative coronary angiography (QCA) were retrospectively studied. . At the time of stent implantation and at 7 months post-stenting 675 patients had a follow-up angiography. Statistical analysis was made with the chi-square test for categorical variables, unpaired t test for continuous variables, univariate or multivariate regression for baseline. And angiographic characteristics and the Kaplan-Meier method for rate of target lesion revascularization (TLR). Results Stent restenos A total of 675 patients with 1074 lesions were approach to angiographic follow-up for 7 months on average. Of these lesions, 448 were implanted with BMS while 626 lesions with DES. At 7 months, bare-metal in-stent restenosis occured in 148 lesions (33.0%), and bare metal in-segment restenosis in 155 lesions (34.6%) in contrast to drug-eluting in-stent restenosis in 48 lesions (7.7% ) and drug-eluting in-segment restenosis in 73 lesions (11.7%) (P<0.001 compared with BMS respectively). Late loss in both in-stent and in segment was higher in BMS than in DES groups [(1.00±0.69) Vs (0.28±0.52); (0.78±0.71) vs (0.21±0.52), P<0.001 equal]. Angulated lesion, lesion length, pre-procedural minimal luminal diameter (MLD), and BMS were independent predictors for TLR, ( P<0.01 respectively), but in the current smoker, ostial lesion, and stent overlapping, post-procedure in-stent MLD, lesion length, and stent types were ind EpendeNt predictors for in-segment restenosis (P<0.01 respectively). Standard coronary risk factors such as hypertension, hyperlipidemia, diabetes, and history of CAD were not associated with a higher rate of restenosis caused by BMS or DES implantation in our Chinese Han ethnicity Population. Conclusions Coronary stenting including BMS or DES implantation in Chinese Han ethnic patients is associated with a restenosis rate comparable to that demonstrated in previous studies from the western countries, and predictors of stent restenosis are somehow different from those in the western population.
其他文献
临床越来越多的病例表明:皮试显示“阴性”后接受足量青霉素输入,依然会导致皮疹、呕吐甚至哮喘等过敏现象发生,严重者还可能因呼吸困难危及生命。专家指出,对于青霉素皮试呈
9月13日,中国疾病预防控制中心提示公众慎用抗生素,对抗生素使用要坚持不随意买药、不自行选药、不任意服药、不随便停药的“四不”原则;14日,卫生部再次重申这一意见。究其
目前抗菌药物的滥用现象非常严重,已引起国家卫生部的重视。专家们一再呼吁要加强管理,但是收效不大,除了有关医生没能按原则开药外,病 At present, the phenomenon of abus
医疗保障与医疗救助任玉岭委员:去年,我们先后走访了东、中、西部9个省市,所见所闻使我们切实感受到医疗问题已成了百姓生活的大难题。很多人有病不敢进医院,“小病拖、大病
1988—1989年在哈尔滨市郊、伊春、大庆、绥化等地的保护地黄瓜植株上采集具有花叶、疱斑、皱缩和矮化等症状的病害病标样174份。经生物测定、蚜虫传播、体外稳定性测定和血
数位时代对映的当然是底片时代,基本上两者之间大部分的理论没有改变,比方说:黑白给你中性、红黄给予温暖、蓝紫给予冷或干净的联想……等等。那么不同的地方是什么呢?底片的
为害芒果的象虫,我国目前已知有13种,其中属于食叶性的有4种,即芒果跳象Rhynchaenus mangiferae Marshee、芒果切叶象Deporaus manginatus Pascoe、蓝绿象Hypor- Damage to
作者发现斜纹夜蛾危害人参、西洋参,严重影响其生长.观察了斜纹夜蛾的生活习性,并调查分析了近年发生危害的原因,提出了防治意见. The authors found that Spodoptera litur
目的探讨不同剂量的醋酸丙氨瑞林对人子宫内膜癌裸鼠皮下移植瘤生长的抑制及端粒重复因子2(telomeric repeat binding factor-2,TRF2)表达的影响。方法选取雌性裸鼠34只,无菌
分析农业减产减收原因,使我们注意到作物感病毒病是一个重要方面。笔者调查了玉米、高粱、谷子、大豆、棉花、花生、甘薯等7种大田作物及杏、桃、李、苹果、梨、葡萄等6种果