外科治疗缺血性心力衰竭STICH的研究课件.ppt

1、 1000 patients 96 clinical sites 23 countries 1231 daysMED+CABG(610)MED+CABG(499)MED(602)MED+CABG+SVR(501)Stratum An=10611MED(527)2MED+CABG(534)Stratum Cn=8596MED+CABG(423)7MED+CABG+SVR(436)Stratum Bn=2163MED(75)5MED+CABG+SVR(65)4MED+CABG(76)2020/11/47 Baseline4 Months020406080CABG(N=212)Baseline4 M

2、onthsCABG+SVR(N=161)ESVI82 ml/m277 ml/m283 ml/m267 ml/m2 Baseline(N=499)LatestFollow-up(N=435)0100200300400500CABGCCS Angina ClassBaseline(N=501)LatestFollow-up(N=428)CABG+SVRCCS Angina ClassPatientsNo Angina121Class I-II130Class III-IV248No Angina339Class I-II88Class III-IV8No Angina128Class I-II12

3、9Class III-IV244No Angina339Class I-II83Class III-IV6Angina symptoms improved by an average of 1.7 classes in both cohorts(P=0.84).Baseline(N=499)LatestFollow-up(N=436)0100200300400500CABGNYHA HF ClassBaseline(N=501)LatestFollow-up(N=435)CABG+SVRNYHA HF ClassPatientsClass I 36Class II222Class III-IV

4、241Class I165Class II190Class III-IV80Class I 50Class II207Class III-IV244Class I179Class II188Class III-IV62Heart failure symptoms improved by an average of one classIn both cohorts(P=0.70).Patients00.10.20.30.40.50.60.7012345Event RateYears from RandomizationCABG49950131931927027522021699112323CAB

5、GCABG+SVRNo.at Risk292 events00.10.20.30.40.50.60.7012345Event RateYears from RandomizationCABGCABG+SVRHR 0.99(95%CI:0.84,1.17),P=0.90 49950131931927027522021699112323CABGCABG+SVRNo.at Risk 292 events289 events 00.10.20.30.40.50.60.7012345Mortality RateYears from RandomizationCABG4995014344294174043

6、633522011935953CABGCABG+SVRNo.at Risk141 deaths00.10.20.30.40.50.60.7012345Mortality RateYears from RandomizationCABG+SVRHR 1.00(95%CI:0.79,1.26),P=0.98 4995014344294174043633522011935953CABGCABG+SVRNo.at Risk141 deaths 138 deathsCABG 0.51.02.0CABG+SVG BetterCABGBetterSubgroupNHR(95%CI)P ValueAll Su

7、bjects10000.99(0.84,1.17)Age0.48 653911.06(0.83,1.35)284660.90(0.70,1.17)#of diseased vessels 50%0.21 1 or 23620.87(0.65,1.13)36381.07(0.87,1.31)Left main 50%or proximal LAD 75%0.53 No1790.89(0.61,1.30)Yes8211.02(0.85,1.22)0.51.02.0CABG+SVG BetterCABGBetterSubgroupNHR(95%CI)P ValueMitral regurgitation 0.44 None or trace3630.89(0.68,1.17)Mild(2+)4491.12(0.88,1.43)Mod.or severe 1780.94(0.65,1.36)Stratum0.44 B1411.15(0.76,1.76)C8590.96(0.81,1.15)Region0.41 Poland2881.02(0.76,1.37)USA2001.10(0.79,1.54)Canada1540.77(0.50,1.18)West Europe1640.80(0.53,1.22)Other1941.24(0.81,1.91)