冠状动脉斑块负担预测冠状动脉内关节切除术后的术后心血管事件
Mingxin Gao1, Wanwan Wen2,3, Chengxiong Gu1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Frontiers in cardiovascular medicine
|June 26, 2023
概括
最长的冠状动脉斑块长度是冠状动脉旁路移植后外科手术期心肌梗塞的重要预测因子. 这一发现可能有助于识别患有心血管事件风险较高的患者.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 生物标志物 生物标志物
背景情况:
- 冠状动脉外置移植 (CABG) 冠状动脉内切除术 (CE) 后心血管事件的风险因素尚不清楚.
- 在接受非抽CABG + CE的患者中预测外科手术期间心血管事件需要进一步调查.
研究的目的:
- 评估冠状动脉斑块负担,冠状动脉解剖狭窄和血清生物标志物的临床价值,用于预测外抽CABG+CE后的外术心血管事件.
- 在接受非抽CABG + CE的患者中确定外科手术期心肌梗塞 (PMI) 的预测因素.
主要方法:
- 对125名患者进行了回顾性队列研究,这些患者接受了非 CABG + CE.
- 冠状动脉斑块负担量化为斑块长度-最大 (CE 删除的最大斑块长度).
- 主要终点是手术前心肌梗塞 (PMI).
主要成果:
- 与没有PMI (1.6 ± 0.9厘米) 的患者相比,PMI (2.4 ± 1.5厘米) 的患者的斑块最大长度显著更高.
- 斑块长度-最大值为1.15厘米独立预测PMI (AUC:0.67,灵敏度:87.9%,特异性:59.8%).
- 斑块最大长度≥1.15厘米的患者患PMI的风险增加了5倍以上 (OR:5.89).
- 干白素-6,CD68和骨质素水平与斑块长度-max相关.
结论:
- 冠状动脉最大斑块长度 (斑块长度-max) 是PMI的优越预测因子,与传统的心血管风险因素相比,在非 CABG + CE 后.
- 斑块最大长度升高可能表明系统性和斑块炎症状况升高,有助于PMI风险.
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