摘要
目的:对女性患者经桡动脉与经股动脉路径行经皮冠状动脉介入治疗(PCI)的安全性和疗效进行评价。方法:回顾性纳入阜外医院2006-01-01至2011-04-30间行PCI的女性患者5 067例,其中,经桡动脉路径者4 105例(桡动脉组),经股动脉路径者962例(股动脉组)。采用1:1倾向性评分匹配模型对两种路径进行配对,成功匹配897对患者。比较两组路径行PCI的安全性及疗效。结果:经过倾向性评分匹配后,两组患者的临床特点、造影与介入相关信息均基本相似。在倾向性评分匹配的患者中,桡动脉组出血学术研究联合会(BARC)分级≥2级和≥3级出血事件以及穿刺点并发症发生率仍显著低于股动脉组(P均<0.05)。桡动脉组的院内主要不良心血管事件(MACE)、心肌梗死、靶血管血运重建事件率均低于股动脉组,但差异均无统计学意义(P均>0.05);心原性死亡率显著低于股动脉组(P<0.05),但经过倾向性评分匹配后此差异亦无统计学意义(P>0.05)。多因素Logistic回归结果显示,桡动脉路径是PCI后严重出血(OR=0.64,95%CI:0.54～0.76,P<0.001)和穿刺点并发症(OR=0.67,95%CI:0.61～0.74,P<0.001)的独立阴性预测因素。结论:对于女性患者而言,经桡动脉路径行PCI能够显著减少严重出血及穿刺点并发症的发生。
Objectives： This study sought to compare both the safety and efficacy of transradial （TRI） versus transfemoral （TFI） approach in women undergoing percutaneous coronary intervention （PCI） in China. Methods： We retrospectively analyzed data from 5 067 women undergoing PCI in Fuwai Hospital, Beijing, China between 2006 and 2011.4 105 patients underwent TRI and 962 patients underwent TFI. A One-to-one propensity score matching （PSM） was performed to control for potential biases. A total of 897 pairs were matched. Results： After controlling for confounders using PSM, baseline and procedural characteristics were well-balanced between TRI and TFI groups. Patients undergoing TRI had significantly fewer major post-PCI bleeding （1.0% vs 3.5%, P〈0.001） and access site complications （8.5% vs 19.7%, P〈0.001） after PSM. There was no statistical differences in the incidence rates of major adverse cardiac events （a composite of cardiac death, myocardial infarction, and target vessel revascularization） during hospitalization （P〉0.05）. Multiple logistic regression analysis showed that TRI was an independent predictor of reduced major bleeding （OR=0.64, 95%CI： 0.54-0.76, P〈0.001） and access site complications （OR=0.67, 95%CI： 0.61-0.74, P〈0.001）. Conclusions： Our result show that TRI is related to reduced major bleeding and access site complications as compared to TFI in Chinese female patients undergoing PCI.
作者
徐奕
金辰
乔树宾
吴永健
颜红兵
窦克非
徐波
杨进刚
杨跃进
XU Yi;JIN Chen;QIAO Shu-bin;WU Yong-jian;YAN Hong-bing;DOU Ke-fei;XU Bo;YANG Jin-gang;YANG Yue-jin(Department of Cardiology,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing（100037）,China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第10期958-963,共6页
Chinese Circulation Journal
基金
中国医学科学院医学与健康科技创新工程(2016-12M-1-0099)
