糖尿病患者药物洗脱支架置入后冠状动脉再狭窄的多种预测因素

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:tianyemin
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Objectives: To identify parameters influencing the likelihood of restenosis after implantation of drug-eluting stents(DES) in patients with diabetes. Methods: Stented patients(n=840)with DES were retrospectively reviewed for inclusion in the study from the Multicenter PCI Database Registry. From this database, 211(25.1%) of 840 patients with six-month angiographic follow up had diabetes. Predictors of coronary restenosis were identified with univariate and multivariate logistic regression analyses. Results: Restenosis occurred in 92 of 629(14.6%) patients without diabetes and in 44(20.9%) of 211 patients with diabetes(p< 0.001). Multivariate parameters for predicting restenosis in the diabetic group were current smoking(odds ratio(OR) 1.923, 95%confidence interval(Cl) 1.055 to 4.725, p=0.036), higher C reactive protein concentration(OR 1.031, 95%Cl 1.011 to 1.075, p=0.043), use of the paclitaxel-eluting stent(OR 2.638, 95%Cl 1.338 to 5.200, p=0.005), longer stent length(OR 1.065, 95%Cl 1.021 to 1.119, p=0.033), smaller reference diameter before DES implantation(OR 0.501, 95%Cl 0.110 to 0.965, p=0.040), smaller reference diameter(OR 0.455, 95%Cl 0.120 to 0.814, p=0.026) and minimum lumen diameter(OR 0.447, 95%Cl 0.068 to 0.876, p=0.039) after DES implantation. Conclusion: Even with the introduction of DES, diabetes remains a significant predictor of coronary restenosis, especially in cases of a small baseline vessel size, small vessel size after percutaneous coronary intervention, longer stent length, use of the paclitaxel-eluting stent, current smoking and high C reactive protein concentration. Methods: Stented patients (n = 840) with DES were retrospectively reviewed for inclusion in the study from the Multicenter PCI Database Registry . From this database, 211 (25.1%) of 840 patients with six-month angiographic follow up had diabetes. Predictors of coronary restenosis were identified with univariate and multivariate logistic regression analyzes. Results: Restenosis occurred in 92 of 629 (14.6%) patients without diabetes and in 44 (20.9%) of 211 patients with diabetes (p <0.001). Multivariate parameters for predicting restenosis in the diabetic group were current smoking (odds ratio 1.923, 95% confidence interval (Cl) 1.055 to 4.725 , p = 0.036), higher C reactive protein concentration (OR 1.031, 95% Cl 1.011 to 1.075, p = 0.043), use of the paclitaxel- eluting stent (OR 2.638, 95% Cl 1.338 to 5.200, p = 0.005) longer stent length (OR 1.065, 95% Cl 1.021 to 1.119, p = 0.033), smaller reference diameter before DES implantation (OR 0.501, 95% Cl 0.110 to 0.965, p = 0.040), smaller reference diameter (OR 0.455, 95% Cl 0.120 to 0.814, p = 0.026) and After lumen diameter (OR 0.447, 95% Cl 0.068 to 0.876, p = 0.039) after DES implantation. Conclusion: Even with the introduction of DES, diabetes remains a significant predictor of coronary restenosis, especially in cases of a small baseline vessel size, small vessel size after percutaneous coronary intervention, longer stent length, use of the paclitaxel-eluting stent, current smoking and high C reactive protein concentration.
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