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NEJM:介入治疗或对稳定性冠状动脉疾病患者无益

2020-04-09 MedSci原创 MedSci原创

对于稳定的冠状动脉疾病和中重度缺血患者,与保守药物治疗相比,积极介入策略不能降低缺血性心血管事件或任何原因死亡风险

近日,研究人员比较了对于稳定的冠状动脉疾病和中重度缺血患者,接受侵入性治疗干预与保守治疗的临床结果差异。
 
5179例中、重度缺血患者随机接受介入治疗策略(适时进行血管造影和血运重建)和药物治疗组,或保守策略(先进行药物治疗,失败后进行介入治疗)。研究的主要结果是由心血管原因、心肌梗死、不稳定心绞痛、心力衰竭或复苏性心脏骤停住院引起的死亡,关键的次要结果是死于心血管原因或心肌梗死。
 
在3.2年的随访期间,侵入组发生318例主要结果事件,保守组发生352例主要结果事件。在6个月时,侵入组的累积事件率为5.3%,保守策略组为3.4%(差异1.9%);在5年时,累积事件率分别为16.4%和18.2%(差异-1.8%)。组间次要结果相似。侵入组有145例死亡,保守组有144例死亡(危险比为1.05)。
 
研究认为,对于稳定的冠状动脉疾病和中重度缺血患者,与保守药物治疗相比,积极介入策略不能降低缺血性心血管事件或任何原因死亡风险。
 
原始出处:
 
David J. Maron et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med, April 9, 2020.

 

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    2020-04-09 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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