在无症状或最小症状的大动脉狭窄症中通过导管大动脉置换的结果
Chetan P Huded1, Suzanne V Arnold1, David J Cohen2
1Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri - Kansas City, Kansas City, Missouri, USA.
JACC. Cardiovascular interventions
|September 22, 2023
概括
通过导管的大动脉置换 (TAVR) 为严重的大动脉狭窄症的微症状患者提供了有利的生存结果. 虽然健康状况的改善是温和的,但TAVR增加了在手术后生活良好的可能性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 健康 结果 研究 研究 结果
背景情况:
- 在严重的大动脉狭窄症的微症状患者中,通过导管大动脉置换 (TAVR) 的结果尚未得到充分确立.
- 了解TAVR在这个人群中的疗效对于临床决策至关重要.
研究的目的:
- 评估TAVR在患有严重大动脉狭窄和正常左心室喷射率的患者中的临床和健康状况结果.
- 具体地比较最小症状和较多症状的患者群体之间的结果.
主要方法:
- 从STS/ACC TVT注册表对2015年至2021年间接受TAVR的患者的数据分析.
- 根据堪萨斯城心肌病问卷总体总结得分 (KCCQ-OS) 定义的最小症状状态≥75.
- 在最小症状和中度/严重症状组之间比较生存和健康状况指标.
主要成果:
- 在231,285名TAVR患者中,20%的患者出现了最小的症状.
- 微症状患者的1年生存率更高 (调整HR为0.70),活着和健康的几率更高 (OR为1.19).
- 健康状况 (KCCQ-OS) 的改善在较少症状患者中较小,而在较多症状患者中则较小.
结论:
- 在严重的大动脉狭窄症的微症状患者中,TAVR产生了有利的生存结果.
- 尽管健康状况的改善较小,但TAVR在一年后改善了健康生存的可能性.
- 这些发现支持在精心挑选的症状最小的个体中考虑TAVR.
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