切割球囊对老年轻中度冠状动脉钙化病变患者远期预后的影响  

The effect of cutting balloon on the long-term prognosis of mild-to-moderate coronary artery calcification lesions in the elderly

作　　者：王亚芳 荣素然 石向欣 杨晓欧 许金金 王敬祥 Wang Yafang;Rong Suran;Shi Xiangxin;Yang Xiao'ou;Xu Jinjin;Wang Jingxiang(Department of Geriatrics,Baoding No.1 Central Hospital,Baoding 071000,China;Department of Cardiology,Baoding No.1 Central Hospital,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院老年病科,071000 [2]河北省保定市第一中心医院心血管内科,071000

出　　处：《中华老年病研究电子杂志》2024年第3期19-23,共5页Chinese Journal of Geriatrics Research(Electronic Edition)

基　　金：保定市科技计划项目(2141ZF078)

摘　　要：目的探讨切割球囊对老年轻中度冠状动脉钙化病变患者远期预后的影响。方法连续纳入2018年1—12月于保定市第一中心医院就诊的老年冠心病患者,经冠状动脉造影证实存在冠状动脉狭窄合并轻中度冠脉钙化共1901例,根据使用球囊不同分为切割球囊组158例和普通球囊组1743例。依据两组患者的基线资料,以1:1进行倾向评分匹配(PSM),两组各143例。随访5年,以发生主要不良心脑血管事件(MACCE)为终点,采用Kaplan-Meier生存曲线比较PSM后两组发生MACCE的情况,应用Cox比例风险回归模型分析发生MACCE的风险。结果286例患者中54例(18.9%)发生MACCE。Kaplan-Meier生存曲线分析显示,与普通球囊组相比,切割球囊组发生MACCE、全因死亡、靶血管血运重建、支架内血栓形成的风险较低(P<0.05或0.01)。校正混杂因素后的多因素Cox比例风险回归模型分析显示,切割球囊与MACCE、全因死亡、急性心肌梗死、靶血管血运重建、支架内血栓形成、缺血性脑卒中的风险较低相关(P<0.05或0.01)。结论切割球囊治疗可改善轻中度冠状动脉钙化老年患者的远期预后。Objective To investigate the effect of cutting balloon on the long-term prognosis of mild-to-moderate coronary artery calcification lesions in the elderly.Methods Elderly patients with coronary heart diseases treated in the Baoding No.1 Central Hospital from January to December 2018 were included.Coronary artery stenosis combined with mild-to-moderate coronary artery calcification was confirmed by coronary angiography.A total of 1901 patients were divided into 158 cases in the cutting balloons group and 1743 cases in the conventional balloon group.A propensity score matching(PSM)model was established and matched 1:1 with 143 cases in each group.After 5 years of follow-up,the incidence of major adverse cardiovascular and cerebrovascular event(MACCE)in the two groups after PSM was compared through Kaplan-Meier survival curve,and the risk of MACCE was analyzed by Cox proportional hazard regression model.Results MACCE occurred in 54 of 286 patients(18.9%).Kaplan-Meier survival curve analysis showed that the risk of MACCE,all-cause death,target vessel revascularization,and in-stent thrombosis was lower in the cutting balloon group compared with those in the conventional balloon group(P<0.05 or P<0.01).Multivariate Cox proportional hazard regression model analysis showed that compared with conventional balloon dissection,cutting balloon dissection was associated with a lower risk of MACCE,all-cause death,acute myocardial infarction,target vessel revascularization,in-stent thrombosis,and ischemic stroke(P<0.05 or P<0.01).Conclusion Cutting balloon therapy improves long-term prognosis in elderly patients with mild-to-moderate coronary artery calcification.

关 键 词：冠状动脉钙化病变 老年人 切割球囊 倾向评分匹配 远期预后 

分 类 号：R541.4[医药卫生—心血管疾病]