王娟,许浩博,乔树宾,管常东,崔锦钢,张敏

• 1:国家心血管病中心北京协和医学院中国医学科学院阜外医院冠心病中心
• 2:永铭诚道(北京)医学科技股份有限公司

摘要(Abstract)：

目的 探讨SYNTAX评分对冠状动脉单双支病变经皮冠状动脉介入治疗患者术后1年临床不良事件的预测价值。方法 PANDAⅢ临床试验是一项前瞻性、多中心、全人群、随机对照研究，共入选了2013年12月至2014年8月来自46家中心的2 348例患者。前瞻性地收集所有患者的SYNTAX评分，其中有1 663例为冠状动脉单支或双支病变患者。根据SYNTAX评分将患者分为3组，其中SYNTAX评分≤22分为低分组（1 388例），22分32分为高分组（63例）。结果 低、中、高分组中分别有1 378例（99.28%）、211例（99.53%）、63例（100.00%）患者完成了1年随访。主要不良心血管事件（MACE）发生率分别为低分组6.31%(87/1 378)、中分组10.90%(23/211)、高分组20.63%(13/63)，差异有统计学意义（P<0.001）。高分组全因死亡率明显高于低、中分组（11.11%比1.45%比1.42%,P<0.001）。所有患者心肌梗死的发生率随着SYNTAX评分的升高而增加（3.63%比7.58%比14.29%,P<0.001）。低、中、高分组中靶病变失败（TLF）事件的发生率差异也有统计学意义（4.57%比9.95%比12.70%,P<0.001）。随着SYNTAX评分升高靶血管心肌梗死的发生率增高（3.27%比7.58%比12.70%,P<0.001）。多因素分析显示年龄（HR 1.039,95%CI 1.020～1.057,P<0.001）和术前SYNTAX评分（HR 1.031,95%CI 1.012～1.050,P<0.001）是发生MACE的危险因素。结论 对于冠状动脉单双支病变患者，SYNTAX评分是MACE的独立危险因素且有较好的预测价值。

关键词(KeyWords)： SYNTAX评分;经皮冠状动脉介入治疗;冠心病;主要不良心血管事件;靶病变失败

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划（2020YFC1107200）

作者(Author): 王娟,许浩博,乔树宾,管常东,崔锦钢,张敏

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