经皮冠状动脉介入治疗史对冠状动脉旁路移植术后生存的影响  

Impact of prior pecutaneous coronary intervention on survival following coronary artery bypass grafting

作　　者：赵彩虹 何萌[1] 崔颢 任长伟[1] 来永强[1] ZHAO Caihong;HE Meng;CUI Hao;REN Changwei;LAI Yongqiang(Department of Structural Heart Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所结构性心脏病外科,100029

出　　处：《心肺血管病杂志》2024年第12期1300-1304,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都医科大学优秀青年项目(KCA2305)。

摘　　要：目的:对比研究PCI治疗史对CABG术围术期及长期的影响。方法:回顾性研究于北京安贞医院行不停跳CABG术的1210例患者,观察了围术期并发症及远期生存率。结果:1210例患者中有148例既往接受过PCI,这些患者糖尿病发生率以及陈旧性心肌梗死发生率显著高于无PCI史的患者。术中总桥血管数量显著少于无PCI史的患者。两组患者围术期并发症无明显差异,但有PCI史的患者中远期生存率显著低于对照组(HR=2.57,P=0.023)。纳入性别、年龄等多因素Cox分析显示,PCI史(HR=2.98,95%CI:1.26~7.06,P=0.013)仍是术后长期死亡率的独立危险因素。结论:PCI史可降低CABG术后长期生存率。Objective:To investigate the impact of PCI on the perioperative and long-term outcomes of CABG.Methods:We reviewed 1210 cases of patients who underwent off-pump CABG in Beijing Anzhen Hospital.Perioperative and long-term outcomes were compared.Results:Among the 1210 patients,148 had previous PCI.Patients with a history of prior PCI had significantly higher rates of diabetes and prior myocardial infarction compared to those without PCI history.Additionally,the total number of bypass grafts in patients with a history of PCI was significantly lower than those without PCI history.There were no significant differences in perioperative complications between the two groups,but patients with a PCI history had significantly lower long-term survival rates compared to the control group(P=0.023).Multivariate Cox analysis showed that a history of PCI(HR=2.98,95%CI:1.26-7.06,P=0.013)remains an independent risk factor for long-term mortality.Conclusion:A history of PCI can reduce the long-term survival rate after CABG surgery.

关 键 词：冠状动脉旁路移植术 经皮冠状动脉介入 桥血管数量 生存率 

分 类 号：R54[医药卫生—心血管疾病]