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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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延迟病变和慢性病患者的心血管事件
Takehiro Hata1, Hisao Otsuki1, Hiroyuki Arashi2
1Department of Cardiology, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
Heart and vessels
|July 10, 2023
概括
患有慢性病 (CKD) 的血液透析患者面临更高的心血管事件风险,即使有延迟冠状动脉病变. 对这些高风险个体来说,谨慎管理至关重要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 临床结果 临床结果
背景情况:
- 慢性病 (CKD) 的进展与心血管事件有关.
- 晚期冠状动脉病变患者中CKD恶化和心血管事件之间的关联仍未得到充分研究.
- 延迟病变,定义为分数流量储备 (FFR) > 0.80,通常是保守地管理.
研究的目的:
- 调查慢性病 (CKD) 的不同阶段与延迟冠状动脉病变患者心血管事件之间的关联.
- 为了比较早期CKD,晚期CKD和末期脏病患者在血液透析中的临床结果.
主要方法:
- 回顾性研究包括推迟冠状动脉病变 (FFR > 0.80) 的患者,接受医学治疗.
- 患者被分为三组:CKD阶段1-2,CKD阶段3-5和CKD阶段5D (血液透析).
- 主要终点:目标血管心肌梗塞,缺血驱动的再血管化或全因死亡. 结果与使用日志等级测试和多变量Cox比例危险模型进行比较.
主要成果:
- 主要终点的发生率在血液透析组 (CKD5D阶段) 与早期CKD阶段相比显著更高 (p < 0.0001).
- 多变量分析证实,血液透析患者的初级终点风险高于CKD阶段1-2 (HR:2.14;95%CI1.02-4.49;p <0.01).
- 延迟病变的发病率随着CKD严重程度的增加而增加,尤其是血液透析组 (32.4%) 的发病率更高.
结论:
- 需要血液透析的慢性病 (CKD) 患者具有显著增加重大心血管不良事件的风险,即使有延迟冠状动脉病变.
- 在血液透析患者中延迟病变的保守管理需要仔细考虑,因为风险增加.
- 对这种脆弱人群的风险分层和管理策略进行进一步的研究是有必要的.
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