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【JACC】药物洗脱支架与金属裸支架对全因死亡的
Long-Term Impact of Drug-Eluting Stents Versus Bare-Metal Stents on All-Cause Mortality
abstract:
Objectives: Our purpose was to examine the incidence of all-cause mortality among drug-eluting stents (DES) and bare-metal stents (BMS) while adjusting for many confounding factors generally not considered in prior studies.
Background: DES use in the U.S. declined by up to 50% in recent years, primarily due to concerns about late stent thrombosis and possibly increased mortality. However, recent data suggest that DES are as safe as BMS and may actually be associated with a lower incidence of myocardial infarction and mortality.
Methods: All patients undergoing percutaneous coronary intervention with a DES or BMS alone from March 1, 2003, to June 30, 2007, at a tertiary care center were assessed. Multivariable Cox proportional hazards modeling was performed for overall and propensity-matched patients. Socioeconomic status was calculated using U.S. Census 2000 data. The primary end point was all-cause mortality.
Results: There were a total of 832 deaths over a 4.5-year interval among 8,032 patients. Of these, 6,053 received a DES and 1,983 patients had a BMS. All-cause mortality was significantly lower in unadjusted and adjusted Cox proportional models with DES (hazard ratio: 0.62, 95% confidence interval: 0.53 to 0.73; p < 0.001). Similarly, in the propensity-matched group, DES remained associated with lower mortality compared with BMS (adjusted hazard ratio: 0.54, 95% confidence interval: 0.45 to 0.66; p < 0.001).
Conclusions: DES were associated with lower mortality in this "real-world" setting. However, despite multiple adjustments, potential confounding may still play a role 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 。 title:
Long-Term Impact of Drug-Eluting Stents Versus Bare-Metal Stents on All-Cause Mortality
abstract:
标题：药物洗脱支架与裸金属支架对全因死亡的长期影响
Objectives: Our purpose was to examine the incidence of all-cause mortality among drug-eluting stents (DES) and bare-metal stents (BMS) while adjusting for many confounding factors generally not considered in prior studies.
目的：我们目的是调查药物洗脱支架（DES）和裸金属支架(BMS)全因死亡的发生率，虽然在以前的研究中由于为了适应许多混杂因素它通常不被考虑。
Background: DES use in the U.S. declined by up to 50% in recent years, primarily due to concerns about late stent thrombosis and possibly increased mortality. However, recent data suggest that DES are as safe as BMS and may actually be associated with a lower incidence of myocardial infarction and mortality.
背景：在美国，最近几年药物洗脱支架的使用减少了50%，主要是因为担心晚期的支架血栓形成和可能增加的死亡率。然而，最近的数据提示药物洗脱支架与裸金属支架一样安全，并且事实上可能伴随更低的心肌梗死发生率和死亡率。
Methods: All patients undergoing percutaneous coronary intervention with a DES or BMS alone from March 1, 2003, to June 30, 2007, at a tertiary care center were assessed. Multivariable Cox proportional hazards modeling was performed for overall and propensity-matched patients. Socioeconomic status was calculated using U.S. Census 2000 data. The primary end point was all-cause mortality.
方法：所有被评价的患者都是2003年3月1日到2007年6月30日在一个三级护理中心单独使用药物洗脱支架或裸金属支架行经皮冠脉介入术的患者。多变量舵手比例危险率模型在全部和自然倾向配对的患者中完成。社会经济状况使用美国2000年人口普查数据计算。主要的终点是全因死亡。
Results: There were a total of 832 deaths over a 4.5-year interval among 8,032 patients. Of these, 6,053 received a DES and 1,983 patients had a BMS. All-cause mortality was significantly lower in unadjusted and adjusted Cox proportional models with DES (hazard ratio: 0.62, 95% confidence interval: 0.53 to 0.73; p < 0.001). Similarly, in the propensity-matched group, DES remained associated with lower mortality compared with BMS (adjusted hazard ratio: 0.54, 95% confidence interval: 0.45 to 0.66; p < 0.001).
结果：8032患者在4.5年的间期中共有832人死亡。在这些人当中，6053人接受了药物洗脱支架，1983名患者接受裸金属支架。全因死亡率在使用药物洗脱支架的未修正的和修正的舵手比例危险率模型中明显更低（危害比：0.62，有效区间为95%的相关指数：0.53到0.73；p < 0.001）。相似地，在自然倾向配对组，与裸金属支架相比，药物洗脱支架仍然伴有更低的死亡率（修正的危害比：0.54，有效区间为95%的相关指数：0.45到0.66；p < 0.001）。
Conclusions: DES were associated with lower mortality in this "real-world" setting. However, despite multiple adjustments, potential confounding may still play a role
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作者:admin@医学,生命科学 2010-10-27 05:11
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