2007药物洗脱支架进展来自真实世界的数据分析ppt课件

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1、ConcernsfromDataAnalysisintheReal-WorldShengshouHuM.D.,FACCDepartmentofCardiacSurgeryFuWaiHospital,Beijing,ChinaDES2007UPDATETextbook&TheoryDrug-elutingStentsDrugbasedtherapeuticsBare-metalStentsEvolutionofCardiologyTheEraofDrug-elutingStentsMoreCADpatientspreferDESIpreferalessin

2、vasiveandmorecomfortabletherapy…TheEraofDrug-elutingStentsInthepraiseofDES,controversiesneverstopTheEraofDrug-elutingStentsSafetyandeffectiveness:RemainedunansweredDESvs.BMS:DifferentresultsfromdifferentRCTsDESvs.CABG:3RCTsareongoingEditorialsinNEJMonsafetyandefficacyofDESTheEraof

3、Drug-elutingStentsRestatetheindicationforDESCYPHER:targetlesion≤30mmTAXUS:targetlesion≤28mmTheEraofDrug-elutingStentsWhatisthecurrentstatusofDESinthereal-world?TheEraofDrug-elutingStentsTooperfectdesignedtoconsiderthedifferenceamonghospitals,physiciansEnrolledpatientsarerelativehe

4、althierandexcludepatientsathighriskSelectionbiasanduncontrolled,butcanreflexthetruthinthereal-worldTheEraofDrug-elutingStentsDESinTheReal-worldDESinTheReal-worldDESinTheReal-worldDESinTheReal-worldArevolutionbroughtbyDES?DESseemstobeanoptimalchoice*DESreducesrateofstentrestenosisc

5、omparedwithBMS.*HowmuchwillDESbenefitpatientsinthereal-world?*CanDESmaintainitsadvantagecomparedwithbypassinthereal-world?DESinTheReal-worldDataanalysisfromNewYorkStateRegistryDatabaseDESinTheReal-worldTRIALDESIGNPatientsStatisticalAnalysis17400multi-vesselpatientsDESn=9,963(atlea

6、stoneDES)CABGn=7,437Follow-upachievedin99.0%18monthsPropensityAnalysisKaplan-MeiermethodCoxproportionalhazardsmodelsDESinTheReal-worldDES:18-mthrateofrevascularization>30%DESinTheReal-world18-mthSurvivalAnalysisCABGissuperiortoDESintermofTotalMortalityDESinTheReal-world18-mthSurvi

7、valAnalysisforMICABGissuperiortoDESintermofMyocardialInfarctionDESinTheReal-worldSubgroupAnalysisDESinTheReal-worldCABGremainsthestandardofcareforpatientswhorequiremultivesselcoronaryrevascularization.However,stentsmaybeanalternativeforpatientsathighriskforsurgicalcomplicationsorw

8、henaninformedpatientchoosesalessi