切割或棘突球囊预扩张对药物涂层球囊治疗冠状动脉病变预后影响  

Analysis of the effect of cutting or spinous process balloon pre-dilatation on the prognosis of drug-coated balloon in the treatment of coronary artery disease

作　　者：崔哲 高超 张富洋 刘建正 付国涛 王琼 陶凌 CUI Zhe;GAO Chao;ZHANG Fu-yang;LIU Jian-zheng;FU Guo-tao;WANG Qiong;TAO Ling(Department of Cardiology,First Affiliated Hospital,Air Force Medical University,Xi’an 710032,Shaanxi,China)

机构地区：[1]空军军医大学第一附属医院心脏内科,陕西西安710032

出　　处：《心脏杂志》2024年第3期262-265,270,共5页Chinese Heart Journal

摘　　要：目的研究在单纯使用药物涂层球囊(drug-coated balloon,DCB)治疗冠脉病变时,不同预处理方式与患者临床预后的关系。方法前瞻连续性地纳入2015年12月1日~2019年12月1日在我院行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)并接受单纯DCB治疗的单个靶病变患者,共2027例。2027例患者中,仅使用半顺应性或者高压球囊预处理的614例作为对照组,使用切割或棘突球囊预处理的1413例患者作为观察组。主要终点事件为36个月血管相关复合终点,次要终点事件为心源性死亡、靶血管心肌梗死和靶血管血运重建。结果两组患者基线资料无显著差异。对照组年龄和糖尿病患病率高于观察组(均P<0.05)。对照组的回旋支占比较高(P<0.05),观察组的前降支占比较高(P<0.05)。随访36个月显示,观察组的血管相关复合终点、心源性死亡、靶血管心肌梗死和靶血管血运重建事件的发生率显著低于对照组。结论对仅使用DCB治疗的冠心病患者,随访36个月显示,使用切割球囊联合DCB治疗冠脉病变是安全有效的,并伴随有更低的血管相关复合终点。AIM To study the relationship between different pretreatment methods and clinical prognosis of patients with coronary artery disease treated with drug-coated balloon(DCB).METHODS The study prospectively included 2027 patients with single target lesions who underwent percutaneous coronary intervention(PCI)and received DCB alone in our hospital from December 1,2015 to December 1,2019.Among the 2027 patients,only semi-compliant or high-pressure balloon preconditioning was used as the control group,and 1413 patients with cutting or spinous process balloon preconditioning were used as the observation group.The main end events were 36-month vascular-related composite end points,and the secondary end events were cardiogenic death,target vessel myocardial infarction and target vessel revascularization.RESULTS There was no significant difference in baseline data between the two groups of patients.The age and prevalence of diabetes in the control group were higher than those in the observation group(P<0.05).The control group had a higher proportion of convoluted branches(P<0.05),while the observation group had a higher proportion of anterior descending branches(P<0.05).The 36 month follow-up showed that the incidence of vascular related composite endpoint,cardiac death,target vessel myocardial infarction and target vessel revascularization events in the observation group was significantly lower than that in the control group.CONCLUSION For patients with coronary heart disease treated only with DCB,the 36-month follow-up showed that cutting balloon combined with DCB was safe and effective in the treatment of coronary artery disease,accompanied by lower vascular-related composite endpoints.

关 键 词：切割球囊 药物涂层球囊 预扩张 

分 类 号：R541.4[医药卫生—心血管疾病]