在罪祸首血管冠状动脉干预期间发现的偶然无症状病变的临床进展
Ruchira Glaser1, Faith Selzer, David P Faxon
1University of Pennsylvania, Philadelphia, PA 19104, USA.
Circulation
|December 30, 2004
概括
大约6%的接受皮肤冠状动脉干预 (PCI) 的患者在一年内在非目标病变中经历了斑块进展. 多血管冠状动脉疾病增加了需要进一步PCI治疗这些病变的风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 药物释放支架的出现已经降低了恢复率,将重点转移到皮肤冠状动脉干预 (PCI) 期间管理偶然的非目标病变.
- 传统上由于缩风险而保守地管理,这些病变现在被认为是PCI,以防止斑块不稳定.
- 未经治疗的偶发性狭窄症对未来心脏事件的临床影响尚不清楚.
研究的目的:
- 确定非目标病变中临床斑块进展的发生率和特征.
- 确定与这些病变中需要重复PCI相关的风险因素.
- 评估患有进展非目标病变的患者的临床结果.
主要方法:
- 使用国家心脏,肺和血液研究所动态注册表进行的回顾性队列研究.
- 分析了1997年至1999年间连续接受PCI的患者.
- 评估临床斑块进展和需要非目标病变PCI在1年的随访.
主要成果:
- 在3747名PCI患者中,5.8%的患者需要在1年内进行额外的非目标病变PCI来治疗临床斑块进展.
- 其中,59%出现了新的不稳定性心痛,9.3%出现了非致命的心肌梗塞.
- 患有多血管冠状动脉疾病的患者需要非目标病变PCI的可能性显著更高 (OR为2个血管1.72,OR为3个血管3.37).
- 需要后续PCI的病变通常最初是<或=60%的狭窄 (86.9%),从平均41.8%的狭窄症进展到83.9%.
结论:
- 在接受PCI的患者中,大约6%的患者在一年内在非目标病变中经历临床斑块进展,需要进一步干预.
- 冠状动脉疾病的较高负担是这些病变中临床斑块进展的重要预测因素.
- 这些发现强调了考虑对某些非目标病变进行干预的重要性,以防止未来的不良心脏事件.
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