www.onlinejacc.org 中文版 /CHINESE EDITION 原创性研究 2018 年 12 月 第3期 ELSEVIER ISSN 0735-1097 1 比伐卢定或肝素在行介入治疗的急性冠脉综合征 患者中的应用 Giuseppe Gargiulo, Greta Carrara, et al ■ 点评 韩雅玲 李洋 13 双联抗血小板治疗评分在瑞典全国人群中的外部 验证 Peter Ueda, Tomas Jernberg, et al ■ 点评 高展 窦克非 徐波 23 急性冠脉综合征患者行完全血运重建与单纯罪犯 血管血运重建的对比研究 Krishnaraj S. Rathod, Sudheer Koganti, et al ■ 点评 于波 代建南 34 伴或不伴心力衰竭患者的 B 型钠尿肽水平和死亡率 Michelle K. York, Deepak K. Gupta, et al ■ 点评 韩雅玲 李洋 43 外科与经皮冠脉血运重建治疗后卒中的发生率 Stuart J.Head, Milan Milojevic, et al ■ 点评 陈纪言 冯颖青 何旭瑜 55 与 2017 年 ACC/AHA 高血压指南定义的 1 期高 血压相关的长期心血管疾病风险 Yue Qi, Xueyu Han, et al ■ 点评 陈绍良
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EDITOR-IN-CHIEF
Valentin Fuster, MD, PhD,New York, NY
EXECUTIVE EDITORJagat Narula, MD, PhD, New York, NY
DEPUTY EDITOR
Jonathan L. Halperin, MD,New York, NY
GUEST EDITORSDeepak L. Bhatt, MD, MPH,Boston, MA
P.K. Shah, MD, Los Angeles, CA
VICE PRESIDENT, PUBLISHINGKimberly Murphy,Washington, DC
EDITORIAL DIRECTOR
Justine Varieur Turco, Washington, DC
INTERNATIONAL ADVISORS
Jane Armitage, FRCP,Oxford, United Kingdom
Edimar A. Bocchi, MD,Sao Paulo, Brazil
Antonio Colombo, MD,Milan, Italy
Gerd Heusch, MD, PhD,Essen, Germany
Chang-Sheng Ma, MD,Beijing, China
Gilles Montalescot, MD, PhD, Paris, France
José C. Nicolau, MD, PhD,Sao Paulo, Brazil
Han Ya-Ling, MD, PhD, Shenyang, China
中文版/CHINESE EDITION
主编 / Editor-in-Chief韩雅玲 / Yaling Han
单位 / Affiliation沈阳军区总医院 / PLA Shenyang General Hospital
副主编(按姓氏拼音排序)
编 委(按姓氏拼音排序) Editorial Board Members(Sequenced by family names)
Social Media Editor Dr. Mingyu Sun社交媒体编辑 孙鸣宇
Jiannan Dai The Second Affiliated Hospital of Harbin Medical University
Kefei Dou Fuwai Hospital,CAMS
Yingqing Feng Guangdong General Hospital
Zhan Gao Fuwai Hospital,CAMS
Jing Li Xuanwu Hospital, Capital Medical University
Yang Li PLA Shenyang General Hospital
Yi Li PLA Shenyang General Hospital
Zhizhong Liu Nanjing First Hospital Affiliated to Nanjing Medicine University
Xiao Wang Beijing Anzhen Hospital, Capital Medical University
Lei Xing The Second Affiliated Hospital of Harbin Medical University
Junqing Yang Guangdong General Hospital
Junjie Zhang Nanjing First Hospital Affiliated to Nanjing Medicine University
Jiyang Chen Guangdong General Hospital
Shaoliang Chen Nanjing First Hospital Affiliated to Nanjing Medicine University
Shaoping Nie Beijing Anzhen Hospital, Capital Medical University
Bo Xu Fuwai Hospital,CAMS
Bo Yu The Second Affiliated Hospital of Harbin Medical University
From the aDepartment of Cardiology, Bern University Hospital, Bern, Switzerland; bDepartment of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy; cAdvice Pharma Group S.r.l., Milan, Italy; dDepartment of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, and Faculty of Medicine and Life Sciences Hasselt University, Hasselt, Belgium; eSC Terapia Intensiva Cardiologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; fEUSTRATEGY Association, Forli’, Italy; gCardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy; hMaria Cecilia Hospital, GVM Care and Research, Cotignola (RA), Italy; iCardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3, Turin, Italy; jDivision of Cardiology, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy; kStruttura complessa di Cardiologia ASST di Vimercate, Italy; lDepartment of Cardiology, ASL3 Ospedale Villa Scassi, Genoa, Italy; mInterventional Cardiology Unit, Clinica Mediterranea, Naples, Italy; nAzienda Ospedaliera Universitaria Policlinico “Gaetano Martino”, University of Messina, Messina, Italy; oSC Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; pUO Cardiologia, Azienda USL Toscana Sudest, Grosseto, Italy; qInterventional Cardiology Unit, Ospedale San Giovanni Bosco, Turin, Italy; rASST Bergamo ovest, Ospedale di Treviglio (BG), Italy; sCardiovascular Interventional Unit, Cardiology Department, S.Anna Hospital, Como, Italy; tUniversity Hospital “Maggiore della Carità”, Novara, Italy; uASST Fatebenefratelli-Sacco, Milan, Italy; vFondazione Monasterio-CNR-Regione Toscana, Toscana, Italy;
wCasa di Cura Villa Verde, Taranto, Italy; xSimple Departmental Emodynamic Structure, Ospedale Sirai–Carbonia, Carbonia, Italy; yHumanitas Research Hospital, IRCCS, Rozzano, Italy; zCardiovascular Department, Infermi Hospital, Rimini, Italy; aaDepartment of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Policlinico Umberto I, “Sapienza”, University of Rome, Rome, Italy; bbStruttura complessa di Emodinamica, ASST Monza, Ospedale di Desio, Italy; ccPoliclinico San Marco, Zingonia, Italy; ddInterventional Cardiology, Sandro Pertini Hospital, Rome, Italy; eeClinic of Cardiovascular Disease, IRCCS Policlinico San Martino, Genoa, Italy; ffMater Salutis Hospital-Legnago, Verona, Italy; ggMaastricht University Medical Center, and Zuyderland MC, Maastricht, the Netherlands; hhSahlgrenska University Hospital, Göteborg, Sweden; and the iiClinic Cardiovascular Institute, University Hospital Clinic, IDIBAPS (Institut d' Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain. The trial was sponsored by the Società Italiana di Cardiologia Invasiva (GISE, a non-profit organization), which received grant support from The Medicines Company and TERUMO. This substudy did not receive any direct or indirect funding. Dr. Gargiulo has received research grant support from the Cardiopath PhD program. Dr. Vranckx has received speaking or consulting fees from Bayer Health Care and Daiichi-Sankyo. Dr. Leonardi has received grants and personal fees from AstraZeneca; and personal fees from Chiesi, Daiichi-Sankyo, and The Medicines Company. Dr. Varbella has received speaking or consulting fees from Boeringher Ingelheim, Daiichi-Sankyo, Bayer, Pfizer, AstraZeneca, OrbusNeich, Biosensors, AbbottVascular, Amgen, and Bristol-Myers Squibb; and has received grants from Medtronic, Boston Scientific, Abbott, St. Jude, Biosensors, CID Alvimedica, and Abbott Vascular. Dr. Andò has received nonfinancial support from Terumo during the study; personal fees from Daiichi-Sankyo, Pfizer, and AstraZeneca; and personal fees and nonfinancial support from Bayer. Dr. Cortese has received research grants from AB Medica, Abbott, St. Jude Medical, and Stentys; and personal fees from Abbott, AstraZeneca, Daiichi-Sankyo, and Eli Lilly and Stentys. Dr Sciahbasi has served as advisory board member for Bayer HealthCare. Dr van't Hof has received speaker fees from The Medicines Company; has received unrestricted grants from Medtronic and AstraZeneca; and has served as Executive Board member of the EUROMAX trial. Dr. Omervoic has been a member of the advisory board for Boston Scientific; and has received a research grant from AstraZeneca. Dr. Windecker has received research grants from Abbott, Amgen, Bracco, Boston Scientific, Biotronick, St. Jude, and Terumo. Dr. Valgimigli has received grants from The Medicines Company, Terumo, and AstraZeneca; and has received personal fees from Terumo, St. Jude Vascular, and Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.Manuscript received November 19, 2017; revised manuscript received January 11, 2018, accepted January 12, 2018.
无关的出血。(经桡动脉入路和全身性应用比伐卢定最小化出血不良事件 [Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX, MATRIX];NCT01433627)
1. Valgimigli M, Frigoli E, Leonardi S, et al. Bivalirudin or unfractionated heparin in acute coronary syndromes. N Engl J Med 2015;373:997–1009.2. Gargiulo G, Moschovitis A, Windecker S, Valgimigli M. Developing drugs for use before, during and soon after percutaneous coronary intervention. Expert Opin Pharmacother 2016;17:803–18.3. Stone GW. Procedural anticoagulation in myocardial infarction. N Engl J Med 2017;377:1198–200.4. Valgimigli M, Gargiulo G. Bivalirudin in current practice: melius abundare quam deficere? J Am Coll Cardiol Intv 2016;9:1321–3.5. Steg PG, van 't Hof A, Hamm CW, et al. Bivalirudin started during emergency transport for primary PCI. N Engl J Med 2013;369:2207–17.6. Zeymer U, van 't Hof A, Adgey J, et al. Bivalirudin is superior to heparins alone
with bailout GP IIb/IIIa inhibitors in patients with ST-segment elevation myocardial infarction transported emergently for primary percutaneous coronary intervention: a pre-specified analysis from the EUROMAX trial. Eur Heart J 2014;35:2460–7.7. Han Y, Guo J, Zheng Y, et al. Bivalirudin vs heparin with or without tirofiban during primary percutaneous coronary intervention i n a c u t e m y o c a r d i a l i n f a r c t i o n : t h e BRIGHT randomized clinical trial. JAMA 2015;313:1336–46.8. Shahzad A, Kemp I , Mars C, et al . Unfractionated heparin versus bivalirudin in primary percutaneous coronary intervention ( H E AT- P P C I ) : a n o p e n - l a b e l , s i n g l e centre, randomised controlled trial. Lancet 2014;384:1849–58.9. Erlinge D, Omerovic E, Frobert O, et al. Bivalirudin versus heparin monotherapy in myocardial infarction. N Engl J Med 2017;377:1132–42.
10. Valgimigli M, Gagnor A, Calabro P, et al. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet 2015;385:2465–76.11. Capodanno D, Gargiulo G, Capranzano P, Mehran R, Tamburino C, Stone GW. Bivalirudin versus heparin with or without glycoprotein IIb/IIIa inhibitors in patients with STEMI undergoing primary PCI: an updated meta-analysis of 10,350 patients from five randomized clinical trials. Eur Heart J Acute Cardiovasc Care 2016;5:253–62.12. Stone GW, Witzenbichler B, Guagliumi G, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med 2008;358:2218–30.
双联抗血小板治疗评分在瑞典全国人群中的外部验证External Validation of the DAPT Score in a Nationwide PopulationPeter Ueda, MD, PHD,a Tomas Jernberg, MD, PHD,b Stefan James, MD, PHD,c,d Joakim Alfredsson, MD, PHD,e,f David
Erlinge, MD, PHD,g Elmir Omerovic, MD, PHD,h,i Jonas Persson, MD, PHD,b Annica Ravn-Fischer, MD, PHD,i Per Tornvall,
MD, PHD,j Bodil Svennblad, PHD,d Christoph Varenhorst, MD, PHDc,k
From the aClinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; bDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden; cDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; dUppsala Clinical Research Center, Uppsala University, Uppsala, Sweden; eDepartment of Cardiology, Linköping University, Linköping, Sweden; fDepartment of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden; gDepartment of Cardiology, Skåne University Hospital, Lund University, Lund, Sweden; hDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; iDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; jDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; and kPfizer AB, Sollentuna, Sweden. This work was supported by Stiftelsen för ålderssjukdomar, Karolinska Institutet. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Dr. James has served on the advisory board for AstraZeneca and Bayer; has received institutional research grants from AstraZeneca; has received research grants from Janssen and Bayer; and has received grants and personal fees from The Medicines Company. Dr. Alfredsson has received lecture fees from AstraZeneca, Novartis, Merck, and Sanofi; has served on the advisory board for Bristol-Myers Squibb, Sanofi, and Eli Lilly; and has received grant support from AstraZeneca. Dr. Erlinge has received personal fees from AstraZeneca, during the conduct of the study. Dr. Omerovic has received grants from AstraZeneca and Abbott; and has received personal fees from AstraZeneca. Dr. Svennblad has received institutional grants from AstraZeneca. Dr. Varenhorst has received institutional grants and advisory board fees from AstraZeneca; and is after the conduct of this work but before the submission of this paper an employee of Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.Manuscript received April 26, 2018; revised manuscript received May 31, 2018, accepted June 4, 2018.
为减少缺血事件的再发,冠状动脉支架植入术后患
者需要接受包括阿司匹林和一种 P2Y12 拮抗剂在内的双联
抗血小板治疗(dual antiplatelet therapy, DAPT)治疗。支
架植入后 1 年以上 DAPT 的获益大部分来源于减少自发
性心肌梗死(myocardial infarction,MI)(即与支架无关
的事件)[1,2]。但是,DAPT 的缺血保护获益被出血风险
PUBLISHED BY ELSEVIER https://doi.org/10.1016/j.jacc.2018.06.023
通信地址 Dr. Peter Ueda, Clinical Epidemiology Division, Department
of Medicine, Solna, Eugeniahemmet, T2,Karolinska Institutet, 171 76
Stockholm, Sweden. E-mail: [email protected]. Twitter: @karolinskainst.
参考文献
1. Mauri L, Kereiakes DJ, Yeh RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014;371:2155–66.2. Bonaca MP, Bhatt DL, Cohen M, et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015;372: 1791–800.3. Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2016;68:1082–115.4. Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur Heart J 2017;39:213–60.5. Matteau A, Yeh RW, Camenzind E, et al. Balancing long-term risks of ischemic and bleeding complications after percutaneous coronary intervention with drug-eluting stents. Am J Cardiol 2015;116:686–93.6. Joyner CD, Peters RJG, Afzal R, et al. Fondaparinux compared to enoxaparin in patients with acute coronary syndromes without ST-segment elevation: outcomes and treatment effect across different levels of risk. Am. Heart J 2009;157: 502–8.7. Yeh RW, Secemsky EA, Kereiakes DJ, et
al. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention. JAMA 2016;315:1735–49.8. Piccolo R, Gargiulo G, Franzone A, et al. Use of the dual-antiplatelet therapy score to guide treatment duration after percutaneous coronary intervention. Ann Intern Med 2017;167:17–25.9. Harada Y, Michel J, Lohaus R, et al. Validation of the DAPT score in patients randomized to 6 or 12 months clopidogrel after predominantly second-generation drug-eluting stents. Thromb Haemost 2017;117:1989–99.10. Yoshikawa Y, Shiomi H, Watanabe H, et al. Validating utility of dual antiplatelet therapy score in a large pooled cohort from 3 Japanese percutaneous coronary intervention studies. Circulation 2018;137:551–62.11. Stefanini GG, Holmes DR. Drug-eluting coronary-artery stents. N Engl J Med 2013;368: 254–65.12. Lagerqvist B, James SK, Stenestrand U, Lindbäck J, Nilsson T, Wallentin L. Long-term outcomes with drug-eluting stents versus baremetal stents in Sweden. N Engl J Med 2007;356: 1009–19.13. Jernberg T, Attebring MF, Hambraeus K, et al. The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Heart 2010;96: 1617–21.
14. Friberg L, Skeppholm M. Usefulness of Health Registers for detection of bleeding events in outcome studies. Thromb Haemost 2016;116: 1131–9.1 5 . T h e G U S T O I n v e s t i g a t o r s . A n international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med 1993;329:673–82.16. Angerås O, Hasvold P, Thuresson M, Deleskog A, ÖBraun O. Treatment pattern of contemporary dual antiplatelet therapies after acute coronary syndrome: a Swedish nationwide population-based cohort study. Scand Cardiovasc J 2016;50:99–107.17. Royston P, Altman DG. External validation of a Cox prognostic model: principles and methods. BMC Med Res Methodol 2013;13:33.18. Van Calster B, Vickers AJ. Calibration of risk prediction models: impact on decision-analytic performance. Med Decis Mak 2015;35:162–9.19. Pasea L, Chung S, Pujades-Rodriguez M, et al. Personalising the decision for prolonged dual antiplatelet therapy: development, validation and potential impact of prognostic models for cardiovascular events and bleeding in myocardial infarction survivors. Eur Heart J 2017; 38:1048–55.20. Camenzind E, Wijns W, Mauri L, et al. Stent thrombosis and major clinical events at 3 years after zotarolimus-eluting or sirolimus-elut ing coronary stent implantat ion: a randomised, multicentre, open-label, controlled
trial. Lancet 2012; 380:1396–405.21. Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009;361:1045–57.22. Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007;357: 2001–15.23. Valgimigli M, Costa F, Lokhnygina Y, et al. Trade-off of myocardial infarction vs. bleeding types on mortality after acute
coronary syndrome: lessons f rom the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial. Eur Heart J 2016;38:ehw525.24. Mehran R, Pocock SJ, Stone GW, et al. Associations of major bleeding and myocardial infarction with the incidence and timing of mortality in patients presenting with non-ST-elevation acute coronary syndromes: a risk model from the ACUITY trial. Eur Heart J 2009;30:1457–66.
25. Ludvigsson JF, Andersson E, Ekbom A, et al. External review and validation of the Swedish national inpatient register. BMC Public Health 2011;11:450.
急性冠脉综合征患者行完全血运重建与单纯罪犯血管血运重建的对比研究Complete Versus Culprit-Only Lesion Intervention in Patients With Acute Coronary Syndromes
Krishnaraj S. Rathod, MD,a Sudheer Koganti, MD,a Ajay K. Jain, MD,a Zoe Astroulakis, MD, PHD,b Pitt Lim, MD,b Roby Rakhit, MD,c Sundeep Singh Kalra, MD,c Miles C. Dalby, MD,d Constantinos O’Mahony, MD,a Iqbal S. Malik, MD,e Charles J. Knight, MD,a Anthony Mathur, MD, PHD,a Simon Redwood, MD,f Alexander Sirker, MD, PHD,a Philip A. MacCarthy, MD, PHD,g Elliot J. Smith, MD,a Andrew Wragg, MD, PHD,a Daniel A. Jones, MD, PHDa
翻译:湖州市中心医院心内科 胡欢欢;审校:中国医学科学院阜外医院 宋莹
摘 要
背景 大部分急性非 ST 段抬高型心肌梗死(non–ST-segment elevation myocardial infarction, NSTEMI)患者存在多
From the aBarts Health NHS Trust, London, United Kingdom; bSt. George' s Healthcare NHS Foundation Trust, St. George' s Hospital, London, United Kingdom; cRoyal Free London NHS Foundation Trust, London, United Kingdom; dRoyal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, London, United Kingdom; eImperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom; fSt. Thomas' NHS Foundation Trust, Guys&St. Thomas Hospital, London, United Kingdom; and the gKings College Hospital, King' s College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom. Dr. Dalby has received research grants from Abbott Vascular, Daiichi-Sankyo/Lily, and Sanofi; and has been a consultant for AstraZeneca, Eli Lilly, Medtronic, Edwards Lifesciences, and Boston Scientific. Dr. Smith has received speakers fees/honoraria from Boston Scientific, Abbott Vascular, Vascular Perspectives, and Biosensors International. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.Manuscript received March 20, 2018; revised manuscript received June 29, 2018, accepted July 30, 2018.
PUBLISHED BY ELSEVIER https://doi.org/10.1016/j.jacc.2018.07.089
1. Hassanin A, Brener SJ, Lansky AJ, Xu K, Stone GW. Prognostic impact of multivessel versus culprit vessel only percutaneous intervention for patients with multivessel coronary artery disease presenting with acute coronary syndrome. Euro-Intervention 2015;11:293–300.2. Hirsch A, Verouden NJ, Koch KT, et al. Comparison of long-term mortality after percutaneous coronary intervention in patients treated for acute ST-elevation myocardial infarction versus those with unstable and stable angina pectoris. Am J Cardiol 2009;104:333–7.3. Anantha Narayanan M, Reddy YN, Sundaram V, et al. What is the optimal approach to a nonculprit stenosis after ST-elevation myocardial infarction: conservative therapy or upfront revascularization? An updated meta-analysis of randomized trials. Int J Cardiol 2016;216:18–24.4. Bainey KR, Mehta SR, Lai T, Welsh RC. Complete vs culprit-only revascularization for patients with multivessel disease undergoing primary percutaneous coronary intervention for STsegment elevation myocardial infarction: a systematic review and meta-analysis. Am
Heart J 2014;167:1–14.e2.5. Bainey KR, Welsh RC, Toklu B, Bangalore S. Complete vs culprit-only percutaneous coronary in tervent ion in STEMI wi th multivessel disease: a meta-analysis and trial sequential analysis of randomized trials. Can J Cardiol 2016;32:1542–51.6. Bangalore S, Kumar S, Poddar KL, Ramasamy S, Rha SW, Faxon DP. Meta-analysis of multivessel coronary artery r e v a s c u l a r i z a t i o n v e r s u s c u l p r i t o n l y revascularization in patients with STsegment elevation myocardial infarction and multivessel disease. Am J Cardiol 2011;107:1300–10.7. Bangalore S, Toklu B, Wetterslev J. Complete versus culprit-only revascularization for STsegment- elevation myocardial infarction and multivessel disease: a meta-analysis and trial sequential analysis of randomized trials. Circ Cardiovasc Interv 2015;8:e002142.8. E lgendy IY, Wen X, Mahmoud A, Bavry AA. Complete versus culprit-only revascularization for patients with multi-vessel disease undergoing primary percutaneous coronary intervention: an updated meta-analysis of randomized trials. Circ Cardiovasc Interv 2016;88:501–5.
9. El-Hayek GE, Gershlick AH, Hong MK, et al. Meta-analysis of randomized controlled trials comparing multivessel versus culprit-only revascularization for patients with ST-segment elevation myocardial infarction and multivessel disease undergoing primary percutaneous coronary intervention. Am J Cardiol 2015;115:1481–6.10. Kowalewski M, Schulze V, Berti S, et al. Complete revascularisation in ST-elevation myocardial infarction and multivessel disease: meta-analysis of randomised controlled trials. Heart 2015;101:1309–17.11. Moretti C, D' Ascenzo F, Quadri G, et al. Management of multivessel coronary disease in STEMI patients: a systematic review and meta-analysis. Int J Cardiol 2015;179:552–7.12. Navarese EP, De Servi S, Buffon A, Suryapranata H, De Luca G. Clinical impact of simultaneous complete revascularization vs. culprit only primary angioplasty in patients with ST-elevation myocardial infarction and multivessel disease: a meta-analysis. J Thromb Thrombolysis 2011;31:217–25.13. Rasoul S, van Ommen V, Vainer J, et al. Multivessel revascularisation versus infarct-related artery only revascularisation during
Rathod et al .ACS 合并 MVD 患者行完全血运重建与单纯罪犯血管血运重建的对比研究
32
the index primary PCI in STEMI patients with multivessel disease: a meta-analysis. Neth Heart J 2015;23:224–31.14. Sekercioglu N, Spencer FA, Lopes LC, Guyatt GH. Culprit vessel only vs immediate complete revascularization in patients with acute ST-segment elevation myocardial infarction: systematic review and meta-analysis. Clin Cardiol 2014;37:765–72.15. Sethi A, Bahekar A, Bhuriya R, Singh S, Ahmed A, Khosla S. Complete versus culprit only revascularization in acute ST elevation myocardial infarction: a meta-analysis. Circ Cardiovasc Interv 2011;77:163–70.16. Villablanca PA, Briceno DF, Massera D, et al. Culprit-lesion only versus complete multivessel percutaneous intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized trials. Int J Cardiol 2016;220:251–9.17. Vlaar PJ, Mahmoud KD, Holmes DR Jr., et al. Culprit vessel only versus multivessel and staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction: a pairwise and network meta-analysis. J Am Coll Cardiol 2011;58:692–703.18. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;64:e139–228.19. Roffi M, Patrono C, Collet JP, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2016;37:267–315.20. Hambraeus K, Jensevik K, Lagerqvist B, et al. Long-term outcome of incomplete revascularization after percutaneous coronary intervention in SCAAR (Swedish Coronary Angiography and Angioplasty Registry). J Am Coll Cardiol Intv 2016;9:207–15.21. Mariani J, Macchia A, De Abreu M, Gonzalez Villa Monte G, Tajer C. Multivessel versus single vessel angioplasty in non-ST elevation acute coronary syndromes: a systematic review and metaanalysis. PloS One 2016;11:e0148756.
22. Brener SJ, Milford-Beland S, Roe MT, Bhatt DL, Weintraub WS, Brindis RG. Culprit-only or multivessel revascularization in patients with acute coronary syndromes: an American College of Cardiology National Cardiovascular Database Registry report. Am Heart J 2008;155:140–6.23. Ijsselmuiden AJ, Ezechiels J, Westendorp IC, et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: a randomized comparison. Am Heart J 2004;148:467–74.24. Kim MC, Jeong MH, Ahn Y, et al. What is optimal revascularization strategy in patients with multivessel coronary artery disease in non-ST-elevation myocardial infarction? Multivessel or culprit-only revascularization. Int J Cardiol 2011;153:148–53.25. Lee HJ, Song YB, Hahn JY, et al . Multivessel vs single-vessel revascularization in patients with non-ST-segment elevation acute coronary syndrome and multivessel disease in the drug-eluting stent era. Clinical Cardiol 2011;34:160–5.26. Palmer ND, Causer JP, Ramsdale DR, Perry RA. Effect of completeness of revascularization on clinical outcome in patients with multivessel disease presenting w i t h u n s t a b l e a n g i n a w h o u n d e r g o percutaneous coronary intervention. J Invasive Cardiol 2004;16:185–8.27. Rosner GF, Kirtane AJ, Genereux P, et al. Impact of the presence and extent of incomplete angiographic revascularization after percutaneous coronary intervention in acute coronary syndromes: the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. Circulation 2012;125:2613–20.28. Shishehbor MH, Lauer MS, Singh IM, et al. In unstable angina or non-ST-segment acute coronary syndrome, should patients with multivessel coronary artery disease undergo multivessel or culprit-only stenting? J Am Coll Cardiol 2007;49:849–54.29. Ludman PF. British Cardiovascular Intervention Society Registry for audit and quality assessment of percutaneous coronary interventions in the United Kingdom. Heart 2011;97:1293–7.30. Muller DW, Topol EJ, Ellis SG, Sigmon KN, Lee K, Califf RM, Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group. Multivessel coronary artery disease: a key predictor of short-term prognosis
after reperfusion therapy for acute myocardial infarction. Am Heart J 1991;121:1042–9.31. Gaffar R, Habib B, Filion KB, Reynier P, Eisenberg MJ. Optimal timing of complete revascularization in acute coronary syndrome: a systematic review and meta-analysis. J Am Heart Assoc 2017;6:e005381.32. Wald DS, Morris JK, Wald NJ, et al. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115–23.33. Gershlick AH, Khan JN, Kelly DJ, et al. Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J Am Coll Cardiol 2015;65:963–72.34. Engstrom T, Kelbaek H, Helqvist S, et al. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3-PRIMULTI): an open-label, randomised controlled trial. Lancet 2015;386:665–71.35. Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol 2010;56:177–84.36. Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol 2012;32:2045–51.37. Vergallo R, Ren X, Yonetsu T, et al. Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque: a 3-vessel optical coherence tomography study. Am Heart J 2014;167:59–67.38. Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol 2006;47 Suppl:C13–8.39. Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O' Neill WW. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000;343:915–22.40. Kastrati A, Neumann FJ, Schulz S, et al. Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction. N Engl J Med 2011;365:1980–9.41. de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. A new ECG sign of proximal LAD occlusion. N Engl J Med 2008;359:2071–3.
Rathod et al .ACS 合并 MVD 患者行完全血运重建与单纯罪犯血管血运重建的对比研究
33
42. Kato M, Dote K, Sasaki S , e t a l . Presentations of acute coronary syndrome related to coronary lesion morphologies as assessed by intravascular ultrasound and optical coherence tomography. Int J Cardiol 2013;165:506–11.43. Tahvanainen M, Nikus KC, Holmvang L, et al. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction. J Electrocardiol 2011;44:495–501.44. FRagmin and Fast Revascularisation during InStability in Coronary artery disease Investigators. Invasive compared with non-invasive treatment in unstable coronary-artery
disease: FRISC II prospective randomised multicentre study. Lancet 1999;354:708–15.45. Cannon CP, Weintraub WS, Demopoulos LA, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med 2001;344:1879–87.46. Fox KA, Poole-Wilson PA, Henderson RA, et al. Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction: the British Heart Foundation RITA 3 randomised trial. Randomized Intervention Trial of unstable Angina. Lancet 2002;360:743–51.
47. Dangas GD, George JC, Weintraub W, Popma JJ. Timing of staged percutaneous coronary intervention in multivessel coronary artery disease. J Am Coll Cardiol Intv 2010;3:1096–9.48. Sardella G, Lucisano L, Garbo R, et al. Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients: the SMILE trial. J Am Coll Cardiol 2016;67:264–72.
伴或不伴心力衰竭患者的 B 型钠尿肽水平和死亡率B-Type Natriuretic Peptide Levels and Mortality in Patients With and Without Heart Failure
Michelle K. York, BS,a,b,* Deepak K. Gupta, MD, MSCI,a,b,* Cassandra F. Reynolds, BS,a,b Eric Farber-Eger, BS,a,b Quinn S. Wells, MD, PHARMD, MSCI,a,b Katherine N. Bachmann, MD, MSCI,a,c,d Meng Xu, MS,a,e Frank E. Harrell, JR, PHD,a,e
Thomas J. Wang, MDa,b
翻译:浙江医院高血压中心 杨奕;审校:中国医学科学院阜外医院 吴伟春
摘 要
背景 心力衰竭(heart failure, HF)患者循环血液中 B 型钠尿肽(B-type Natriuretic Peptide, BNP)的浓度是死亡率的
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From the aVanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee; bDivision of Cardiovascular Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; cDivision of Endocrinology, Vanderbilt University School of Medicine, Nashville, Tennessee; dFaculty Research Scholars Program, Vanderbilt University School of Medicine, Nashville, Tennessee; and the eDepartment of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee. This work was supported by National Heart, Lung, and Blood Institute grants K12 HL109019, 1K23HL128928-01A1, and R01 HL131532 and the National Center for Advancing Translational Sciences of the National Institutes of Health (award UL1TR000445) (Vanderbilt University). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. *Ms. York and Dr. Gupta contributed equally to this work and are joint first authors.Manuscript received October 30, 2017; revised manuscript received February 22, 2018, accepted February 25, 2018.
1.Wang TJ. The natriuretic peptides and fat metabolism.N Engl J Med 2012;367:377–8.2.Levin ER, Gardner DG,Samson WK. N a t r i u r e t i c p e p t i d e s . N E n g l J M e d 1998;339:321–8.3.Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure.N Engl J Med 2002;347:161–7.4.Mukoyama M, Nakao K, Saito Y, et al. Increased human brain natriuretic peptide in congestive heart failure. N Engl J Med 1990;323:757–8.5.Cowie MR, Jourdain P, Maisel A, et al. Clinical applications of B-type natriuretic p e p t i d e ( B N P ) t e s t i n g . E u r H e a r t J 2003;24:1710–8.6.Dao Q, Krishnaswamy P, Kazanegra R, et al. Utility of B-type natriuretic peptide in the diag-nosis of congestive heart failure in
an urgent-care setting. J Am Coll Cardiol 2001;37:379–85.7.Yamamoto K, Burnett JC Jr., Jougasaki M, et al. Superiority of brain natriuretic peptide as a hor-monal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hyper-tension 1996;28:988–94.8.Rothenburger M, Wichter T, Schmid C, et al. Aminoterminal pro type B natriuretic peptide as a predictive and prognostic marker in patients with chronic heart failure. J Heart Lung Transplant 2004;23:1189–97.9.Gustafsson F, Steensgaard-Hansen F, Badskjaer J, Poulsen AH, Corell P, Hildebrandt P. Diagnostic and prognostic performance of N-ter-minal ProBNP in primary care patients with sus-pected heart failure. J Card Fail 2005;11:S15–20.10.De Lemos JA, Morrow DA, Bentley JH, et al. The prognostic value of B-type natriuretic peptide in patients with acute coronary
syndromes. N Engl J Med 2001;345:1014–21.11.Berger R, Huelsman M, Strecker K, et al. B-type natriuretic peptide predicts sudden death in pa-tients with chronic heart failure. Circulation 2002; 105:2392–7.12.Roden DM, Pulley JM, Basford MA, et al. Development of a large-scale de-identified DNA biobank to enable personalized medicine. Clin Pharmacol Ther 2008;84:362–9.13.Patel DK, Green KD, Fudim M, Harrell FE, Wang TJ, Robbins MA. Racial differences in the prevalence of severe aortic stenosis.J Am Heart Assoc 2014;3:e000879.14.Levey AS, Adler S, Caggiula AW, et al. Effects of dietary protein restriction on the progression of advanced renal disease in the Modification of Diet in Renal Disease Study. Am J Kidney Dis 1996;27:652–63.15.Wells QS, Farber-Eger E, Crawford DC. Extraction of echocardiographic data from the electronic medical record is a rapid and
42 JACC VOL. 71, NO. 19, 2018MAY 15, 2018:2079–88
York et al .伴或不伴 HF 患者的 BNP 水平和预后
efficient method for study of cardiac structure and func-tion. J Clin Bioinform 2014;4:12.16.Lang RM, Badano LP, Mor-Avi V, et al. Rec-ommendations for cardiac chamber quantificat ion by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1–39.e14.17.Hanna DB, Pfeiffer MR, Sackoff JE, Selik RM, Begier EM, Torian LV. Comparing the National Death Index and the Social Security Administra-tion’s Death Master File to ascertain death in HIV surveillance. Public Health Rep 2009;124:850–60.18.Krishnaswamy P, Lubien E, Clopton P, et al. Utility of B-natriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction. Am J Med 2001;111:274–9.19.Maisel AS, Koon J, Krishnaswamy P, et al. Utility of B-natriuretic peptide as a rapid, point-of-care test for screening patients undergoing echo-cardiography to determine left ventricular dysfunction. Am Heart J 2001;141:367–74.20.Das SR, Drazner MH, Dries DL, et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study. Circulation 2005;112:2163–8.21.Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardio-vascular events and death. N Engl J Med 2004; 350:655–63.22.Wang TJ, Larson MG, Keyes MJ, Levy D, Benjamin EJ, Vasan RS. Association of plasma
natriuretic peptide levels with metabolic risk fac-tors in ambulatory individuals. Circulation 2007; 115:1345–53.23.Gupta DK, Claggett B, Wells Q, et al. Racial differences in circulating natriuretic peptide levels: the Atherosclerosis Risk In Communities study. J Am Heart Assoc 2015;4.24.Gupta DK, de Lemos JA, Ayers CR, Berry JD, Wang TJ. Racial differences in natriuretic peptide levels: the Dallas Heart Study. J Am Coll Cardiol HF 2015;3:513–9.25.Gupta DK, Daniels LB, Cheng S, et al. Differ-ences in natriuretic peptide levels by race/ethnicity (from the Multi-Ethnic Study of Athero-sclerosis). Am J Cardiol 2017;6:1008–15.26.Omland T, Aakvaag A, Bonarjee VV, et al. Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction. Com-parison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide. Circula-tion 1996;93:1963–9.27.Harrison A, Morrison LK, Krishnaswamy P, et al. B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea. Ann Emerg Med 2002;39:131–8.28.Nakada Y, Kawakami R, Nakano T, et al. Sex dif-ferences in clinical characteristics and long-term outcome in acute decompensated heart failure pa-tients with preserved and reduced ejection fraction. Am J Physiol Heart Circ Physiol 2016;310:H813–20.29.Januzzi JL Jr., Sakhuja R, O’Donoghue M, et al. Utility of amino-terminal pro-brain natriuretic peptide testing for prediction of
1-year mortality in patients with dyspnea treated in the emergency department. Arch Intern Med 2006;166:315–20.30.Meyer B, Huelsmann M, Wexberg P, et al. N-terminal pro-B-type natriuretic peptide is an in-dependent predictor of outcome in an unselected cohort of critically ill patients. Crit Care Med 2007; 35:2268–73.31.Karmpaliotis D, Kirtane AJ, Ruisi CP, et al. Diagnostic and prognostic utility of brain natri-uretic peptide in subjects admitted to the ICU with hypoxic respiratory failure due to noncardiogenic and cardiogenic pulmonary edema. Chest 2007; 131:964–71.32.Fonarow GC, Peacock WF, Phillips CO, et al. Admission B-type natriuretic peptide levels and in-hospital mortality in acute decompensated heart failure. J Am Coll Cardiol 2007;49: 1943–50.33.Lauridsen BK, Iversen K, Hunter I, et al. ProANP plasma measurement predicts all-cause mortality in acutely hospitalised patients: a cohort study. BMJ Open 2013;3:e003288.34.McCormick N, Lacaille D, Bhole V, Avina-Zubieta JA. Validity of heart failure di-agnoses in administrative databases: a systematic review and meta-analysis. PLoS ONE 2014;9: e104519.35.Ledwidge M, Gallagher J, Conlon C, et al. Natriuretic peptide-based screening and collabo-rative care for heart failure: the STOP-HF ran-domized trial. JAMA 2013;310:66–74.
关键词 死亡,电子健康数据,预后,回顾性。
附录 有关扩展的方法部分以及补充表格和
图表,请参阅本文的线上版本。
沈阳军区总医院 韩雅玲 李洋
B 型钠尿肽(BNP)不仅是诊断心衰的金标准,而且对心衰患者的再住院和死亡风险具有预测作用。本研究通过
外科与经皮冠脉血运重建治疗后卒中的发生率Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization
Stuart J.Head, MD, PhD,a Milan Milojevic, MD, MSC,a Joost Daemen, MD, PHD,b Jung-Min Ahn, MD,c Eric Boersma, PHD,b
Evald H.Christiansen, MD, PHD,d Michael J.Domanski, MD,e,f Michael E.Farkouh, MD, MSC,e,f Marcus Flather, MBBS,g Valentin Fuster, MD, PHD,e Mark A.Hlatky, MD,h Niels R. Holm, MD,d Whady A.Hueb, MD, PHD,I Masoor Kamalesh, MD,j
Young-Hak Kim, MD,c Timo Mäkikallio, MD,k Friedrich W. Mohr, MD, PHD,l Grigorios Papageorgiou, MSC,a,m Seung-Jung Park, MD,c Alfredo E. Rodriguez, MD, PHD,n Joseph F. Sabik III, MD,o Rodney H. Stables, MA, DM,p Gregg W. Stone, MD,q Patrick W. Serruys, MD, PHD,r A. Pieter Kappetein, MD, PHDa
间两组的卒中发生率是接近的,PCI 后为 2.2%,CABG 后为 2.1%(HR:1.05; 95% CI:0.80-1.38; P = 0.72)。
治疗和基线临床或血管造影指标对 5 年卒中发生率无显著相关,但在糖尿病(PCI:2.6% vs. CABG:4.9%)和
aDepartment of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands; bDepartment of Cardiology, Erasmus Medical College, Rotterdam, the Netherlands; cDepartment of Cardiology, University of Ulsan College of Medicine,Asan Medical Center, Seoul, South Korea; dDepartment of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; eCardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; fDivision of
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Cardiology, Peter Munk Cardiac Centre and Department of Medicine, Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario,Canada; gDepartment of Medicine and Health Sciences, Norwich Medical School University of East Anglia and Norfolk and Norwich University Hospital, Norwich, United Kingdom; hDepartment of Health Research and Policy, and Department of Medicine(Cardiovascular Medicine), Stanford University School of Medicine, Stanford, California; iHeart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; jDepartment of Cardiology, Richard L. Roudebush Veterans Affairs Medical Center,Indianapolis, Indiana; kDepartment of Cardiology, Oulu University Hospital, Oulu, Finland; lDepartment of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany; mDepartment of Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands; nCardiac Unit, Otamendi Hospital, Buenos Aires, Argentina; oDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; pInstitute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; qDepartment of Cardiology, Columbia University Medical Center and Clinical Trials Center, the Cardiovascular Research Foundation, New York, New York; rDepartment of Cardiology, Imperial College London, London,United Kingdom.This current study was performed without funding. Individual trials did receive funding: SoS (Stent or Surgery) trial received funding from Boston Scientific Corp., Guidant ACS, and Medtronic. MASS II received funding from Zerbini Foundation. ERACI II received funding from Cook Inc. ARTS received funding from Cordis. SYNTAX trial received funding from Boston Scientific Corp. PRECOMBAT trial received funding from the Cardiovascular Research Foundation (Seoul, Korea), Cordis, Johnson and Johnson, and grant 0412-CR02-0704-0001 from Health 21 R&D Project, Ministry of Health and Welfare, South Korea. VACARDS received funding from the VA Cooperative Studies Program. FREEDOM trial was supported by grants U01 01HL071988 and 01HL092989 from the National Heart, Lung, and Blood Institute, Cordis, Johnson and Johnson, Boston Scientific Corp., Eli Lilly, Sanofi, and Bristol-Myers Squibb. BEST received funding from CardioVascular Research Foundation, Abbott Vascular, and grant HI10C2020 from the Korea Healthcare Technology Research and Development Project, Ministry for Health and Welfare Affairs, South Korea. EXCEL trial received funding from Abbott Vascular. NOBLE trial received funding from Biosensors, Aarhus University Hospital, and participating sites. Dr. Daemen has received institutional research grants from Abbott, Acist Medical, Boston Scientific, Pie Medical, St. Jude Medical, ReCor Medical, and Medtronic; and has received consulting fees from Acist, AstraZeneca, Pythagoras Medical, and ReCor. Dr. Farkouh has received research support from Amgen and Novo Nordisk. Dr. Holm has received institutional research grants from Abbott, Biosensors, Biotronik, and Boston Scientific; and has received speaking honoraria from Abbott, Biotronik, and Terumo. Dr. Sabik has served on the Cardiac Surgery Advisory Board of Medtronic; and is the North American surgical principal investigator for the EXCEL trial, sponsored by Abbott. Dr. Stone has received grant support from the Cardiovascular Research Foundation during the conduct of the study; has received personal fees from Velomedix, Toray, Matrizyme, Miracor, TherOx, Reva, V-wave, Vascular Dynamics, Ablative Solutions, Neovasc, and Medical Development Technologies; has received other support from the MedFocus family of funds, Guided Delivery Systems, Micardia, Vascular Nonotransfer Technologies, Cagent, Qool Therapeutics, Caliber, Aria, and the Biostar family of funds outside the submitted work; has served as a consultant on prasugrel patent litigation paid for by Lupin Pharmaceuticals; and his institution, Columbia University, receives royalties from Abbott Vascular for sale of the MitraClip. Dr. Serruys has served as a consultant for Abbott Laboratories, AstraZeneca Pharmaceuticals, Biotronik, Cardialysis B.V., GLG Research, Medtronic, Sino Medical Sciences Technology Inc. Tianjin China, Stentys France, Svelte Medical Systems Inc., Volcano/Philips Europe, Q3Medical Devices Limited, and St. Jude Medical; and has served as a member of the corporate advisory board for Xeltis. Dr. Kappetein is an employee of Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Amar Krishnaswarmy, MD, served as Guest Editor for this paper.Manuscript received March 17, 2018; accepted April 23, 2018.
非糖尿病患者(PCI:2.6% vs. CABG: 2.4%)之间有显著差异(相关性 P=0.004)。与未发生卒中患者比较,术后 30天内发生卒中的患者有较高的 5 年死亡率,无论是 PCI 后(45.7% vs. 11.1%,P< 0.001)还是 CABG 后(41.5% vs. 8.9%,P< 0.001)。
双侧 P<0.05 认为有统计学意义。采用 SPSS 21.0 (IBM Corporation, Armonk, New York)或 R 软件 3.2.4(Institute for Statistics and Mathematics of Wirtschaftsuniversität, Wien, Austria)进行统计分析。
1. Hlatky MA, Boothroyd DB, Bravata DM, et al.Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet 2009;373:1190–7.2. Daemen J, Boersma E, Flather M, et al. Longterm safety and efficacy of percutaneous coronary intervention with stenting and coronary artery bypass surgery for multivessel coronary artery disease: a meta-analysis with 5-year patient-level data from the ARTS, ERACI-II, MASS-II, and SoS trials. Circulation 2008;118:1146–54.3. Stefanini GG, Holmes DR Jr. Drug-eluting coronaryartery stents. N Engl J Med 2013;368:254–65.4. Palmerini T, Biondi-Zoccai G, Reggiani LB, et al.Risk of stroke with coronary artery bypass graft surgery compared with percutaneous coronary intervention. J Am Coll Cardiol 2012;60:798–805.5. Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 2018;391:939–48.6. Stewart LA, Clarke M, Rovers M, et al., for the PRISMA-IPD Development Group. Preferred Reporting Items for Systematic Review and MetaAnalyses of individual participant data: the PRISMA-IPD Statement. JAMA 2015;313:1657–65.
7. Rodriguez A, Bernardi V, Navia J, et al., for ERACI II Investigators. Argentine Randomized Study: Coronary Angioplasty with Stenting versus Coronary Bypass Surgery in patients with MultipleVessel Disease (ERACI II): 30-day and one-year follow-up results. J Am Coll Cardiol 2001;37:51–8.8. Serruys PW, Unger F, Sousa JE, et al. Arterial Revascularization Therapies Study Group. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease.N Engl J Med 2001;344:1117–24.9. Hueb W, Soares PR, Gersh BJ, et al. The Medicine, Angioplasty, or Surgery Study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. J Am Coll Cardiol 2004;43:1743–51.10. SoS Investigators. Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomised controlled trial. Lancet 2002;360:965–70.11. Serruys PW, Morice MC, Kappetein AP, et al.,for the SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009;360:961–72.12. Park SJ, Kim YH, Park DW, et al. Randomized trial of stents versus bypass surgery for left main coronary artery disease. N Engl J Med 2011;364:1718–27.
13. Farkouh ME, Domanski M, Sleeper LA, et al.,for the FREEDOM Trial Investigators. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med 2012;367:2375–84.14. Kamalesh M, Sharp TG, Tang XC, et al.Percutaneous coronary intervention versus coronary bypass surgery in United States veterans with diabetes. J Am Coll Cardiol 2013;61:808–16.15. Park SJ, Ahn JM, Kim YH, et al., for the BEST Trial Investigators. Trial of everolimus-eluting stents or bypass surgery for coronary disease.N Engl J Med 2015;372:1204–12.16. Stone GW, Sabik JF, Serruys PW, et al. , for the EXCEL Trial Investigators. Everolimus-eluting stents or bypass surgery for left main coronary artery disease. N Engl J Med 2016;375:2223–35.17. Makikallio T, Holm NR, Lindsay M, et al., for the NOBLE Study Investigators. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. Lancet 2016;388:2743–52.18. Buszman PE, Kiesz SR, Bochenek A, et al.Acute and late outcomes of unprotected lef t main s tent ing in comparison with surgical revascularization. J Am Coll Cardiol 2008;51:538–45.19. Head SJ, Borgermann J, Osnabrugge RL, et al.Coronary artery bypass grafting: part 2—
optimizing outcomes and future prospects. Eur Heart J 2013;34:2873–86.
通 信 地 址 ADDRESS FOR CORRESPONDENCE: Dr. Stuart J.Head,
Department of Cardiothoracic Surgery, Erasmus University Medical
Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. E-mail:
20. Lamy A, Devereaux PJ, Prabhakaran D, et al.,for the CORONARY Investigators. Off -pump or onpump coronary-ar te ry bypass grafting at 30 days.N Engl J Med 2012;366:1489–97.21. Diegeler A, Borgermann J, Kappert U, et al., for the GOPCABE Study Group. Off-pump versus onpump coronary-artery bypass grafting in elderly patients. N Engl J Med 2013;368:1189–98.22. Börgermann J, Hakim K, Renner A, et al.Clampless off-pump versus conventional coronary artery revascularization: a propensity score analysis of 788 patients. Circulation 2012;126 Suppl 1:S176–82.23. Zhao DF, Edelman JJ, Seco M, et al. Coronary artery bypass grafting with and without manipulation of the ascending aorta: a network metaanalysis. J Am Coll Cardiol 2017;69:924–36.24. Tarakji KG, Sabik JF 3rd, Bhudia SK, Batizy LH,Blackstone EH. Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting. JAMA 2011;305:381–90.25. Myles PS, Smith JA, Forbes A, et al., for the ATACAS Investigators of the
ANZCA Clinical Trials Network. Stopping vs. continuing aspirin before coronary artery surgery. N Engl J Med 2016;374:728–37.26. Villareal RP, Hariharan R, Liu BC, et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J Am Coll Cardiol 2004;43:742–8.27. Kosmidou I, Chen S, Kappetein AP, et al. Newonset atrial fibrillation after PCI or CABG for left main disease: the EXCEL trial. J Am Coll Cardiol 2018;71:739–48.28. Hogue CW Jr., Murphy SF, Schechtman KB,Davila-Roman VG. Risk factors for early or delayed stroke after cardiac surgery. Circulation 1999;100:642–7.29. Iqbal J, Zhang YJ, Holmes DR, et a l . Optimal medical therapy improves clinical outcomes in patients undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting: insights from the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial at the 5-year follow-up. Circulation 2015;131:1269–77.30. Parasca CA, Head SJ, Milojevic M, et al. Incidence, characteristics, predictors, and
outcomes of repeat revascularization after percutaneous coronary intervention and coronary artery bypass grafting: the SYNTAX trial at 5 years. J Am Coll Cardiol Intv 2016;9:2493–507.31. Mack MJ, Head SJ, Holmes DR Jr., et al.Analysis of stroke occurring in the SYNTAX trial comparing coronary artery bypass surgery and percutaneous coronary intervention in the treatment of complex coronary artery disease. J Am Coll Cardiol Intv 2013;6:344–54.32. Stefanini GG, Baber U, Windecker S, et al.Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials. Lancet 2013;382:1879–88.33. Kappetein AP, Head SJ, Genereux P, et al.Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Am Coll Cardiol 2012;60:1438–54.
From the Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; and the Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. *Drs. Qi and Han contributed equally to this work and are joint first authors. This work was supported by the National Key Research and Development Program of China (grant 2016YFC0900902); the National Science & Technology Pillar Program (grants 2011BAI09B01, 2011BAI11B03, 2006BAI01A01, and 2006BAI01A02); and the capital health research and development of special (grant 2016-1-1051). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.Manuscript received April 16, 2018; revised manuscript received June 7, 2018, accepted June 12, 2018.
美国心脏病学会(American College of Cardiology, ACC)/ 美国心脏协会(American Heart Association, AHA)临床
致谢 The authors are grateful to all of the investigators from
participating centers in the CMCS study for providing data collection.
通信地址 Dr. Jing Liu, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China. E-mail:
1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:2199–269.2. Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. A cooperative study. JAMA 1977; 237:255–61.3. The sixth report of the Joint National Commit tee on Prevent ion , Detec t ion , Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997;157:2413–46.4. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117–71.5. Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet 2016;387:251–72.6. Li D, Lv J, Liu F, et al. Hypertension burden and control in mainland China: analysis of nationwide data 2003-2012. Int J Cardiol 2015; 184:637–44.7. Lu J, Lu Y, Wang X, et al. Prevalence, awareness , t r ea tment , and con t ro l o f hypertension in China: data from 1.7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet 2017;390:2549–58.8. Wang Z, Chen Z, Zhang L, et al., for the China Hypertension Survey Investigators. Status of hypertension in China: results from the China Hypertension Survey, 2012-2015.
Circulation 2018;137:2344–56.9. Bundy JD, He J. Hypertension and related cardiovascular disease burden in China. Ann Glob Health 2016;82:227–33.10. NCD Risk Fac to r Col labora t ion . Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet 2017;389:37–55.11. National Bureau of Statistics of the People’s Republic of China. The Sixth National Population Census of the People’s Republic of China. 2010. Available at: http://www.stats.gov.cn/tjsj/pcsj/ rkpc/6rp/indexch.htm. Accessed April 15, 2018.12. Li G, Liu J, Wang W, et al. [Prediction models for the 15 years risk of new-onset hypertension in Chinese people aged from 35 to 64 years old]. Zhonghua Nei Ke Za Zhi 2014;53: 265–8.1 3 . G u D , C h e n J , W u X , e t a l . Prehypertension and risk of cardiovascular disease in Chinese adults. J Hypertens 2009;27:721–9.14. Liu J, Hong Y, D’Agostino RB Sr., et al. Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study. JAMA 2004;291:2591–9.15. Li Y, Liu J, Wang W, Zhao D. The association between within-visit blood pressure variability and carotid artery atherosclerosis in general population. PLoS One 2014;9:e97760.16. Wu Z, Yao C, Zhao D, et al. Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular d i s e a s e s i n C h i n a , p a r t I : m o r b i d i t y and mortal i ty monitor ing. Circulat ion 2001;103:462–8.17. Wang Y, Liu J, Wang W, et al. Lifetime risk for cardiovascular disease in a Chinese population: the Chinese Multi-Provincial Cohort Study. Eur J Prev Cardiol 2015;22:380–8.18. Luepker RV, Apple FS, Christenson RH,
et al. Case definitions for acute coronary heart disease in epidemiology and clinical research studies: a statement from the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation 2003;108:2543–9.19. Brunstrom M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med 2018;178:28–36.20. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Statistical Assoc 1999;94:496–509.21. Wander GS, Ram CVS. Global Impact of 2017 American Hear t Associa t ion/American College of Cardiology Hypertension Guidel ines : a perspect ive f rom India . Circulation 2018;137: 549–50.22. Wang JG, Liu L. Global impact of 2017 American College of Cardiology/American Heart Association Hypertension Guidelines: a perspect ive from China. Circulat ion 2018;137:546–8.23. Muntner P, Carey RM, Gidding S, et al. Potential US population impact of the 2017 ACC/AHA High Blood Pressure Guideline. Circulation 2018; 137:109–18.24. Huang Y, Su L, Cai X, et al. Association of all-cause and cardiovascular mortality with prehypertension: a meta-analysis. Am Heart J 2014; 167:160–8.e1.25. Allen N, Berry JD, Ning H, Van Horn L, Dyer A, Lloyd-Jones DM. Impact of blood pressure and blood pressure change during middle age on the remaining lifetime risk for cardiovascular disease: the cardiovascular lifetime risk pooling project. Circulation 2012;125:37–44.
26. Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet 2013;381:1987–2015.27. Gu D, Reynolds K, Wu X, e t a l . Prevalence, awareness, treatment, and control of hypertension in china. Hypertension 2002;40:920–7.28. World Health Organization International Clinical Trials Registry Platform. Study of Antihypertensive Treatment in Patients with High-normal Blood Pressure and Risk Factors (CHINOM). Available at: http://apps.who.int/trialsearch/Trial2. aspx?TrialID=ChiCTR-TRC-10000848. Accessed April 15, 2018.
29. ClinicalTrials.gov. Intervention for High-normal or Borderline-elevated Blood Pressure in Adults With Type 2 Diabetes (IPAD). Available at: https://clinicaltrials.gov/ct2/show/NCT03264352? Term=IPAD&cntry1=ES%3ACN&rank=1. Accessed April 15, 2018.30. Wang S, Wu H, Zhang Q, Xu J, Fan Y. Impact of baseline prehypertension on cardiovascular events and all-cause mortality in the general population: a meta-analysis of prospective cohort studies. Int J Cardiol 2013;168: 4857–60.31. Guo X, Zhang X, Guo L, et al. Association between pre-hypertension and cardiovascular outcomes: a systematic review and meta-
analysis of prospective studies. Curr Hypertens Rep 2013; 15:703–16.32. Bavishi C, Bangalore S, Messerli FH. Outcomes of intensive blood pressure lowering in older hypertensive patients. J Am Coll Cardiol 2017;69: 486–93.