孙号众,余晓凡,陈鸿武,华锦胜,马礼坤

• 1:安徽省立医院(中国科学技术大学第一附属医院)心血管内科
• 2:安徽省心血管病研究所

摘要(Abstract)：

目的评估一次和分次经皮冠状动脉介入治疗(PCI)完全血运重建对ST段抬高型急性心肌梗死(STEMI)合并多支血管病变(MVD)患者长期预后的影响。方法回顾性纳入安徽省立医院(中国科学技术大学第一附属医院)心血管内科2013年1月至2016年12月615例STEMI合并MVD患者,术后随访3年,排除失访及脱落患者,最终共纳入580例患者,分为一次PCI组(239例)和分次PCI组(341例)。研究终点是3年随访期间发生的主要不良心血管事件(MACE),包括心原性死亡、再发心肌梗死和靶血管血运重建(TVR)。结果 3年的随访中,分次PCI组的MACE发生率为10.9%,一次PCI组为16.7%(P=0.040),同时,分次PCI较一次PCI完全血运重建能有效降低由心原性死亡和再发心肌梗死组成的复合终点(P=0.020)。经多因素Cox回归校正混杂因素后显示,分次PCI组较一次PCI组仍能降低3年随访期间MACE发生率(HR 0.526,95%CI 0.325～0.849,P=0.009)。结论与一次PCI完全血运重建相比,分次PCI完全血运重建治疗能降低STEMI合并MVD患者术后3年由心原性死亡、再发心肌梗死和TVR组成的MACE发生率。

关键词(KeyWords)： 冠状动脉疾病;经皮冠状动脉介入治疗;多支血管病变;主要不良心血管事件

Abstract:

Keywords:

基金项目(Foundation): 安徽省心血管病研究所科研课题（KF2018007）;; 合肥自主创新政策借转补项目（J2019Y02）;; 国家自然科学基金项目（81870192）

作者(Author): 孙号众,余晓凡,陈鸿武,华锦胜,马礼坤

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