FT3/FT4 提高了非ST段升高急性冠状动脉综合征患者的风险评估,根据GRACE 2.0评分进行皮肤冠状动脉干预
Chuyi Han1, Le Wang1, Chunwei Liu1
1Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Angiology
|October 25, 2023
概括
自由三甲氨酸/自由甲状腺素 (FT3/FT4) 的比率是中风和主要心血管和脑血管不良事件 (MACCEs) 的重要预测因子,在皮肤冠状动脉干预 (PCI) 后患有非ST段升高急性冠状动脉综合征 (NSTE-ACS) 的患者中. 当与GRACE评分相结合时,该比率可以改善风险评估.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临床结果研究研究
背景情况:
- 甲状腺激素,特别是自由三甲状腺素 (FT3) 和自由甲状腺素 (FT4),在心血管功能中起着至关重要的作用.
- 在接受穿皮冠状动脉干预 (PCI) 的非ST段升高急性冠状动脉综合征 (NSTE-ACS) 患者中,FT3/FT4比率的预后价值仍未得到充分研究.
研究的目的:
- 为了研究FT3/FT4比率与经过PCI的NSTE-ACS型甲状腺患者的临床结果之间的关联.
- 为了确定FT3/FT4比率是否可以提高全球急性冠状动脉事件注册表 (GRACE) 评分提供的风险分层.
主要方法:
- 一项前性研究包括了1448名患有NSTE-ACS,接受PCI的euthyroid患者.
- 采用多变量考克斯回归分析来评估基于FT3/FT4三位体的不良事件风险.
- 将FT3/FT4比率与GRACE分数相结合的附加值使用C统计,综合歧视改进 (IDI) 和净重新分类指数 (NRI) 来评估.
主要成果:
- 较低的FT3/FT4比率与中风风险增加 (HR 11.380) 和主要心血管和脑血管不良事件 (MACCEs) (HR 3.364) 有显著的关联.
- 结合FT3/FT4比率和GRACE评分,显著改善了风险评估指标 (C统计,IDI,NRI).
结论:
- FT3/FT4比率是一个独立的预后指标,用于长期的MACCE在euthyroid患者的NSTE-ACS接受PCI.
- 将FT3/FT4比率与GRACE评分一起纳入风险评估模型,可以提高高风险患者的识别,并可能指导PCI后的管理策略.
相关概念视频
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
19
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
19
Acute Coronary Syndrome III: Diagnostic Studies
9
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
9
Acute Coronary Syndrome I: Introduction
30
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
30
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
19
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
19
Acute Coronary Syndrome IV: Interprofessional Care
11
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
11
Imaging Studies for Cardiovascular System V: CT
22
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
22


