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周围动脉疾病中的急性四肢缺血
Connie N Hess1, Zhen Huang2, Manesh R Patel2
1Division of Cardiology, Department of Medicine, University of Colorado School of Medicine and CPC Clinical Research, Aurora (C.N.H., W.R.H.).
Circulation
|June 27, 2019
概括
患有先前重血管化,心房动或脚臂指数低的患者,急性肢体缺血 (ALI) 的风险更高. ALI住院显著增加心血管事件,死亡率和截肢的风险.
科学领域:
- 心血管医学
- 血管外科
- 临床试验分析
背景情况:
- 急性四肢缺血 (ALI) 是临床关键事件,也是心血管试验中新出现的结果.
- 需要对ALI风险因素和结果进行全面评估.
研究的目的:
- 在患有外周动脉疾病 (PAD) 的患者中确定与ALI住院相关的基线因素.
- 分析ALI住院对随后的重大心血管不良事件 (MACE),全因死亡率和重大截肢的影响.
主要方法:
- 在PAD中对13885名EUCLID试验患者 (蒂卡格勒勒与克洛皮多格勒) 的分析.
- 考克斯比例危险建模以确定ALI风险因素.
- 使用ALI住院作为时间依赖的共变量,开发二次结果模型.
主要成果:
- 在1. 7%的患者中,有293次ALI住院;较高的风险与先前的复血管化,心房动和下腕指数 (ABI ≤0. 60) 相关.
- 年龄较大和使用他类药物与ALI风险较低有关.
- ALI住院与MACE (HR1. 4),所有原因死亡率 (HR3. 3) 和重大截肢 (HR 34. 2) 的增加有关.
结论:
- 之前的外周再血管,起始心房动和低ABI确定PAD患者患有ALI的高风险.
- ALI是随后心血管和四肢相关发病率和死亡率的重要预测因素.
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