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目的:评价与比较多支冠脉病变行冠状动脉旁路移植术(CABG)与药物洗脱支架(SES)植入的近期与中期治疗效果。方法:入选2007年7月至2010年6月在我院行血管重建术的407例冠心病多支冠脉病变患者,其中251例行DES置入术(DES组),156例行冠脉旁路移植术(CABG组)。比较两组住院期和随访期不良心血管事件(死亡、非致死性心肌梗死、再次血管重建术和脑血管意外)的发生情况。结果:两组的临床和冠脉病变特征相似,CABG组三支病变、前降支近段病变、左主干病变和慢性完全闭塞病变,及陈旧性心梗(OMI)患者数与SES组差异有统计学意义(p﹤0.05)。住院期两组总体不良心血管事件发生率无明显差异,随访367例患者(92.1%),平均临床随访12～36(17±9)个月,2组总体不良心血管事件发生率仍无明显差异(9.2%∶11.4%,P>0.05),但DES组再次血管重建的发生率较CABG组有增高趋势(8.9%∶2.6%,P>0.05)。结论对于多支冠状动脉病变患者,DES置入术安全可行,总体不良心血管事件发生率与CABG无明显差异。
Objective: To evaluate and compare the short-term and long-term effects of coronary artery bypass grafting (CABG) and drug-eluting stent (SES) implantation in patients with multiple branches of coronary artery disease. Methods: A total of 407 patients with coronary artery disease with coronary artery disease undergoing revascularization in our hospital from July 2007 to June 2010 were enrolled. Among them 251 patients underwent DES implantation (DES group) and 156 patients underwent coronary artery bypass Road transplant (CABG group). The incidence of adverse cardiovascular events (death, non-fatal myocardial infarction, revascularization and cerebrovascular accident) during the hospitalization and follow-up periods was compared between the two groups. Results: There were similar clinical and coronary lesions between the two groups. There were significant differences between the three lesions in CABG group, proximal anterior descending artery lesion, left main trunk lesion and chronic total occlusion lesion and the number of patients with old myocardial infarction (OMI) and SES group Statistical significance (p <0.05). There was no significant difference in the overall incidence of adverse cardiovascular events between the two groups during the hospitalization period. The follow-up of 367 patients (92.1%) with an average clinical follow-up of 12 to 36 months (17 ± 9) months showed no significant difference in the overall incidence of adverse cardiovascular events (9.2% vs11.4%, P> 0.05). However, the incidence of revascularization in DES group was higher than that in CABG group (8.9% vs2.6%, P> 0.05). Conclusions DES implantation is safe and feasible in patients with multivessel coronary artery disease. There is no significant difference between the incidence of adverse cardiovascular events and CABG.