检查患者的结局 住院患有并发性外周动脉疾病和微血管疾病的患者
Scott Grubman1, Miguel Algara1,2, Kim G Smolderen1,3
1Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine Yale School of Medicine New Haven CT.
Journal of the American Heart Association
|January 3, 2024
概括
患有外周动脉疾病 (PAD) 和微血管疾病 (MVD) 的患者面临截肢,心脏事件,死亡率和再入院的风险显著增加. 这种不断增长的患者群体需要进一步调查,因为结果不佳.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 公共卫生 公共卫生
背景情况:
- 周围动脉疾病 (PAD) 和微血管疾病 (MVD) 是常见的血管疾病,共享风险因素.
- PAD和MVD的同时发生是一个重大的临床挑战.
- 了解并发性PAD/MVD对患者结局的影响至关重要.
研究的目的:
- 为了描述诊断为PAD和MVD的患者.
- 确定PAD和MVD同时存在对重大不良事件的影响.
- 分析PAD和MVD入院的趋势和相关结果.
主要方法:
- 利用国家再录取数据库 (2011-2018) 来采集超过3300万个入学者的全国样本.
- 将患者分为PAD-only,MVD-only和PAD/MVD组合的患者.
- 使用后勤和考克斯回归来评估截肢,MACE,死亡率和再接收的关联.
主要成果:
- PAD/MVD的入院人数大幅增加,到2018年每年超过50万.
- 2011年至2018年间,PAD/MVD患者的截肢率 (主要和次要) 在PAD/MVD患者中增加了约50%.
- 与仅患有PAD相比,并发性PAD/MVD显著增加了大截肢 (OR1.30),小截肢 (OR2.15),MACE (OR1.04),住院死亡率 (OR1.07) 和1年再入院 (HR1.02) 的风险.
结论:
- 并发性MVD在PAD患者中越来越普遍,并增加了不良结果的风险.
- 这种脆弱的人群经历了明显更糟糕的结果,包括更高的截肢和死亡率.
- 未来的研究对于更好地了解和管理伴随PAD和MVD患者至关重要.
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