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冠状动脉栓塞引起的急性心肌梗塞的患病率,临床特征和预后

Tatsuhiro Shibata1, Shoji Kawakami1, Teruo Noguchi2

  • 1From Departments of Cardiovascular Medicine (T.S., S.K., T. Noguchi, Y.A., T.K., T. Nagai, K. Nakao, M.F., K.K., T.A., Y.G., H.O., S.Y.), Stroke and Cerebrovascular Disease (T.T., K. Nagatsuka), Pathology (H.I.-U.), and Preventive Medicine and Epidemiologic Informatics, Center for Cerebral and Cardiovascular Disease Information (K. Nishimura, Y.M.), National Cerebral and Cardiovascular Center, Suita, Japan.

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|July 29, 2015
PubMed
概括

冠状动脉栓塞 (CE) 影响近3%的急性心肌梗塞患者,通常是由心房动引起的. 这些患者心脏死亡和不良事件的风险显著增加,需要密切监测.

关键词:
急性心肌梗塞心房动冠状动脉血栓形成

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科学领域:

  • 心脏病学
  • 血管医学
  • 血栓形成

背景情况:

  • 冠状动脉栓塞 (CE) 是急性心肌梗塞 (AMI) 的一个未被认可的原因.
  • 关于CE的患病率,临床特征和长期结果的数据有限.
  • 了解CE对于非动脉样硬化性AMI的治疗至关重要.

研究的目的:

  • 确定新发性心脏病患者中CE的患病率和临床特征.
  • 评估治疗策略,住院结果和CE的长期预后.
  • 将CE患者和匹配的非CEAMI队列之间的结果进行比较.

主要方法:

  • 检查了1776名连续的AMI患者 (2001 - 2013年).
  • 使用组织学,血管学和成像学标准诊断出CE.
  • 在中位数49个月的随访期间,用于结果比较的倾向分数匹配.

主要成果:

  • 脑电阻患病率为2. 9% (52名患者),心房动是最常见的原因 (73%).
  • 观察到抗凝剂治疗不足;使用CHA2DS2- VASc的风险分层确定了高风险患者.
  • 心脏病患者心脏病死亡的发生率显著高 (HR 9. 29) 并且5年主要不良事件发生率为27. 1%.

结论:

  • 心房动是冠状动脉栓塞的主要原因.
  • 在急性心肌梗塞患者中,CE患者构成高危人群.
  • 强化后续和优化抗凝策略对于CE患者至关重要.