高臂间血压差异的冠心病患者PCI术后远期不良心脏事件发生情况观察

Occurrence of long-term adverse cardiac events in CHD patients with high IABPD after PCI

目的观察高臂间血压差异(IABPD)的冠心病患者经皮冠状动脉介入治疗(PCI)术后远期不良心脏事件发生情况。方法纳入接受PCI手术治疗且术中植入第二代药物洗脱支架(DES)的冠心病患者855例,入院时或PCI术后1周内使用电子血压计同时测量双上臂血压,计算IABPD。按IABPD值将患者分为高IABPD组(≥10 mmHg)与正常IABPD组(<10 mmHg)。患者均采用门诊、线上或电话随访,随访时间(44.5±26.4)个月,随访临床终点事件为主要不良心脏事件(MACE),包括心血管死亡、MI、卒中和症状驱使的靶血管血运重建(TVR)。结果正常IABPD组患者随访期间共发生112例MACE,其中心血管死亡43例、MI 12例、卒中15例和症状驱使的TVR 64例;高IABPD组患者随访期间共发生80例MACE,其中心血管死亡3例、MI 4例、卒中3例和症状驱使的TVR 14例;其中正常IABPD组患者症状驱使的TVR与高IABPD组相比,P<0.05。结论在接受PCI治疗的冠心病患者中,与正常IABPD(<10 mmHg)患者相比,高IABPD(≥10 mmHg)患者远期随访中症状驱使的TVR发生率更高。

Objective To observe the occurrence of long-term adverse cardiac events in coronary heart disease(CHD)patients with high inter-arm blood pressure difference(IABPD)after percutaneous coronary intervention(PCI).Methods A total of 855 patients with CHD who received PCI and implanted of second-generation drug-eluting stents(DES)were enrolled.The blood pressure of patients’both upper arms was measured by electronic sphygmomanometer at admission or within 1 week after PCI,and IABPD was calculated.Patients were divided into high IABPD group(≥10 mmHg)and normal IABPD group(<10 mmHg).All patients were followed up through outpatient,online or telephone for(44.5±26.4)months.The endpoint events were major adverse cardiac events(MACE),including cardiovascular death,MI,stroke,and symptom-driven target vessel revascularization(TVR).Results A total of 112 cases of MACE occurred in normal IABPD group during follow-up,including 43 cases of cardiovascular death,12 cases of MI,15 cases of stroke,and 64 cases of symptom-driven TVR.In the high IABPD group,80 cases of MACE occurred during follow-up,in-cluding 3 cardiovascular deaths,4 MI,3 stroke,and 14 symptom-driven TVR.The symptom-driven TVR of patients in the normal LABBD group was differently from that of high LABPD group.Conclusion In CHD patients after PCI,the in-cidence of symptom driven TRV in patients with high IABPD(≥10 mmHg)is higher than that of patients with normal IAB-PD(<10 mmHg)during long-term follow-up.