|
Objectives:Discuss NERS score for unprotected left main coronary artery disease patients the prognosis of percutaneous coronary intervention of predictive value. Analysis of different ways of revascularization impact on prognosis.Methods:Retrospective analysis on June,2010-December,2012in Tianjin armed police medical school affiliated hospital heart line with PCI in patients with unprotected left main coronary heart disease patients and138patients with follow-up of success,Acoording to the clinical indicators,angiography and the operation way NERS integral calculation, The primary end point was major adverse cardiac events (MACE),encompassing myocardial infarction, all-cause death, and target vessel revascularization. Patients were divided into two groups complete revascularization group and incomplete revascularization group.compare different revascularization of prognosis.All patients with unprotected left main bifurcation lesions in according to the procedure is divided into one-stent group and DK crush other two-stent techniques (culotte, T-stenting, and classical crush), Comparison results of different operative methods MACE.Results:1.For Ners score of low,mcdiumor high clinical baseline data comparison, Smoking history, low density lipoprotein between three groups of comparative differences have statistical significance(p<0.05).LVEF in low-risk group (56.5±10.4,%), moderate (56.9±10.3,%), risk (48.3±11.8,%), comparison between groups was statistically significant (p<0.001).MACE rates of low, intermediate, and high tertiles according to NERS score were21.4%,39.0%,58.8%,The difference between intermediate score group and low score group was statistically significant,, The difference between high score group and intermediate score group was statistically significant, The difference between high score group and low score group was statistically significant(p<0.05).2.The higher incidence of MACE of complete revascularization group have statistical difference of incomplete revascularization.(54.2%vs.26.3%, P<0.001). The set of incomplete revascularization of the group of MACE were higher than complete revascularization, But the item is no statistical significance3. Ners in high score group, complete blood supply reconstruction and comparison of incidence of MACE of incomplete revascularization was statistically significant (39.1%vs.69.3%, p<0.05).4. Ners integral low integral group completely revascularization and incidence of MACE group of incomplete revascularization is not significant (20.8%vs.47.1%, p>0.05)。5. The unprotected left main Iesion138,one-stent group68,DK crush35, other two-stents techniques35, One-stent groug,was associated with a significantly increased MACE compared to two-stents approache, One-stent groug41.2%, twe-stent group37.2%,DK crush was associated with a significantly decreased18-months MACE compared to the other two-stents approaches or the one-stent approach (DK crush:25.7%vs. other two-stent approaches:48.4%, one-stent approach:41.2%, DK crush group compared with other double stents group MACE rate had statistical significance(p<0.05). one-stent and two-stents mace rate is not significant (p>0.05).The main benefit of DK crush primarily appeared to a reduction in TVR (5.7%vs.31.4%vs.11.8%, p<0.001). DK crush group compared with other double stents groups was statistically significan(p<0.001).Conclusions:1. Compared with high intermediate and low of NERS score incidence of MACE is reducing gradually,NERS score is the ideal tool to predict prognosis of PCI.2. To patients with DES implanted in the ULMCA, complete revascularization effect is better than incomplete.especially fore NERS SCORE high-risk group of patients.3. revascularization.For unprotected left main bifurcation lesion,the rate of mace of DK crush is lower than other two-stents, especially The TVR.
|