李文铮,吴铮,彭红玉,赵东晖,赵烨婧,郑泽,王韶屏,李世英,程姝娟,李佳宣,郭祈涵,刘昊,柳景华

• 1:首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所
• 2:首都医科大学

摘要(Abstract)：

目的研究既往慢性完全闭塞(CTO)病变经皮冠状动脉介入治疗(PCI)失败再次尝试成功的预测因素和术后短期预后。方法回顾性入选2016年1月至2019年12月首都医科大学附属北京安贞医院心内科既往CTO-PCI失败再次尝试的患者。使用logistic单因素和多因素回归分析评价再次PCI的技术成功预测因素。观察终点为术后30 d内全因死亡、Q波心肌梗死、急诊再次血运重建、卒中和出血事件。结果共194例CTO病变患者入选本研究。技术成功率为66%。logistic多因素回归分析显示,闭塞段<20 mm(OR 2.94,95%CI 1.36～6.37)、非钙化病变(OR 2.93,95%CI 1.36～6.30)、远端着陆区充足(OR 4.46,95%CI 2.06～9.66)、Rentrop分级≥2级(OR 5.98,95%CI 2.46～14.51)和首选策略为逆向(OR 10.28,95%CI 3.58～29.50)均为再次尝试成功的预测因素(均P<0.05)。术后30 d整体卒中发生率为2.1%,轻微出血发生率为14.4%,严重出血发生率为2.6%,未发生其他不良事件。结论既往失败CTO-PCI患者再次尝试技术成功的预测因素包括闭塞段<20 mm、非钙化病变、良好的着陆区、Rentrop分级≥2级和首选逆向途径。再次CTO-PCI的成功率尚可接受,需要警惕出血和卒中事件的发生。

关键词(KeyWords)： 慢性完全闭塞;经皮冠状动脉介入治疗;预后

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81970291);; 首都医科大学本科生科研创新项目(XSKY2019207)

作者(Author): 李文铮,吴铮,彭红玉,赵东晖,赵烨婧,郑泽,王韶屏,李世英,程姝娟,李佳宣,郭祈涵,刘昊,柳景华

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