药物涂层球囊治疗中老年急性冠状动脉综合征合并高出血风险对照研究

A controlled study of drug-coated balloon treatment for middle-aged and elderly patients with acute coronary syndrome combined with high bleeding risk

目的探讨药物涂层球囊治疗中老年急性冠状动脉综合征合并高出血风险患者的临床疗效及安全性。方法回顾性收集252例患者临床资料,按治疗方法分为两组,对照组患者(176例)行药物洗脱支架治疗,研究组患者(76例)行药物涂层球囊治疗。比较两组患者的临床基线资料、出血危险因素、冠状动脉造影特点,并电话长期随访应用效果。结果治疗后,研究组患者冠状动脉单支血管病变、支架内再狭窄、冠状动脉迂曲病变发生率高于对照组(P<0.05或0.01);研究组患者冠状动脉三支血管病变发生率、冠状动脉分叉病变发生率、双重抗血小板治疗时间、1年内靶血管血运重建率以及欧美出血学术研究会2、3、5型出血发生率和发生风险低于对照组(P<0.05或0.01)。结论药物涂层球囊治疗中老年急性冠状动脉综合征合并高出血风险患者,具有疗效好、安全性高等优点。

Objective To explore tthe clinical efficacy and safety of drug-coated balloon(DCB)in the treatment of middle-aged and elderly patients with acute coronary syndrome(ACS)complicated by high bleeding risk(HBR).Methods Clinical data of middle-aged and elderly patients with the ACS with the HBR were retrospectively collected,they assigned to two groups according to therapeutic methods,control group(n=176)underwent the drug-eluting stent(DES),and research group(n=76)did the DCB.Such indexes were compared between two groups as clinical baseline data,bleeding risk factors and characteristics of coronary angiogram and long-term telephone follow-up were performed for application effects.Results The occurrence rates of single-vessel coronary artery disease,in-stent restenosis,and tortuous coronary lesions were higher in research than control group(P<0.05 or 0.01);the incidences of triple-vessel coronary artery disease and bifurcation lesions,dual antiplatelet therapy time,target vessel revascularization within 1 year,and the incidences and occurrence risks of type 2,3 and 5 hemorrhage of Bleeding Academic Research Consortium were lower in research than control group(P<0.05 or 0.01).Conclusion The DCB has better curative effect and higher safety in the treatment of middle-aged and elderly patients with the ACS with the HBR.