中华医学杂志（英文版）2012，Vol.125Issue(6)：1000-1004,5.DOI:10.3760/cma.j.issn.0366-6999.2012.06.008
Coronary stenting versus bypass surgery in heart failure patients with preserved ejection fraction
Coronary stenting versus bypass surgery in heart failure patients with preserved ejection fraction
XUE Zeng-ming 1WANG Xiao 1CHEN Fang 1ZHOU Yu-jie 1L(0) Shu-zheng 1HUANG Fang-jiong 2GU Cheng-xiong 2WU Xue-si 1LI Wei-ju 3MA Chang-sheng 1NIE Shao-ping 1DONG Jian-zeng 1LIU Xiao-hui 1KANG Jun-ping 1L(O) Qiang 1DU Xin1
作者信息
- 1. Department of Cardiology,Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
- 2. Department of Cardiac Surgery,Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
- 3. Department of Cardiology, Peking University Hospital, Beijing 100873, China
- 折叠
摘要
Abstract
Background The optimal revascularization strategy in patients with heart failure with preserved ejection fraction (HFPEF) remains unclear.The aim of the present study was to compare the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with HFPEF.Methods From July 2003 through September 2005,a total of 920 patients with coronary artery disease (CAD) and HFPEF (ejection fraction ≥50％) underwent PCI (n=350) or CABG (n=570).We compared the groups with respect to the primary outcome of mortality,and the secondary outcomes of main adverse cardiac and cerebral vascular events (MACCE),including death,myocardial infarction,stroke and repeat revascularization,at a median follow-up of 543 days.Results In-hospital mortality was significantly lower in the PCI group than in the CABG group (0.3％ vs.2.5％,adjusted P=0.016).During follow-up,there was no significant difference in the two groups with regard to mortality rates (2.3％ vs.3.5％,adjusted P=0.423).Patients receiving PCI had higher MACCE rates as compared with patients receiving CABG (13.4％ vs.4.0％,adjusted P ＜0.001),mainly due to higher rate of repeat revascularization (adjusted P ＜0.001).Independent predictors of mortality were age,New York Heart Association (NYHA) class and chronic total occlusion.Conclusion Among patients with CAD and HFPEF,PCI was shown to be as good as CABG with respect to the mortality rate,although there was a higher rate of repeat revascularization in patients undergoing PCI.关键词
revascularization/coronary artery disease/heart failureKey words
revascularization/coronary artery disease/heart failure引用本文复制引用
XUE Zeng-ming,WANG Xiao,CHEN Fang,ZHOU Yu-jie,L(0) Shu-zheng,HUANG Fang-jiong,GU Cheng-xiong,WU Xue-si,LI Wei-ju,MA Chang-sheng,NIE Shao-ping,DONG Jian-zeng,LIU Xiao-hui,KANG Jun-ping,L(O) Qiang,DU Xin..Coronary stenting versus bypass surgery in heart failure patients with preserved ejection fraction[J].中华医学杂志（英文版）,2012,125(6):1000-1004,5.
