左主干末端分叉病变支架术 陈绍良.ppt

左主干末端分叉病变支架术
南京市心血管病医院
南京医科大学附属南京第一医院
南京市第一医院
陈绍良
一、最具影响力的询证医学研究
随访时间:1080天
71% enrolled (N=3,075)
All Pts with de novo 3VD and/or LM disease (N=4,337)
Treatment preference (%)
Referring MD or pts. refused  informed consent (%)
Inclusion/exclusion (%)
Withdrew before consent (%)
Other (%)
Medical treatment (%)
TAXUS
n=903
PCI
n=198
CABG
n=1077
CABG
n=897
no f/u
n=428
5yr f/u
n=649
PCI
all captured w/
follow up
CABG
2500
750 w/ f/u
vs
Total enrollment N=3075
Stratification: LM and Diabetes
Two Registry Arms
Randomized Arms
n=1800
Two Registry Arms
N=1275
Randomized Arms
N=1800
Heart Team (surgeon & interventionalist)
PCI
N=198
CABG
N=1077
Amenable for only one treatment approach
TAXUS*
N=903
CABG
N=897
vs
Amenable for both
treatment options
Stratification: LM and Diabetes
LM
%
3VD
%
LM
%
3VD
%
DM
%
Non DM
%
NonDM
%
DM
%
23 US Sites
62 EU Sites
+
SYNTAX Trial Design
*TAXUS Express
Serruys PW, ESC2008
12 Month LM Subgroup E Rates
CABG
TAXUS
All LMN=705
LM+1VDN=138
LM isolatedN=91
Patients (%)
12 Month LM Subgroup E Rates
CABG
TAXUS
All LMN=705
LM+1VDN=138
LM isolatedN=91
LM+2VDN=218
Patients (%)
12 Month LM Subgroup E Rates
CABG
TAXUS
All LMN=705
LM+1VDN=138
LM isolatedN=91
LM+2VDN=218
LM+3VD
N=258
Patients (%)