对自发冠状动脉剖析的风险和诱发因素的审查
Dragana Stanojevic1, Svetlana Apostolovic1,2, Tomislav Kostic1,2
1Clinic for Cardiology, University Clinical Center Nis, Nis, Serbia.
Frontiers in cardiovascular medicine
|January 3, 2024
概括
自发冠状动脉解剖 (SCAD) 是导致急性冠状动脉综合征 (ACS) 的原因,主要影响女性. 了解其非传统的风险因素是准确诊断和及时治疗的关键.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
背景情况:
- 自发冠状动脉解剖 (SCAD) 占急性冠状动脉综合征 (ACS) 病例的1%-4%.
- SCAD涉及冠状动脉壁层的分离,导致室内血液瘤或虚假光线形成,导致心肌缺血症或心脏病发作.
- 在女性中,SCAD发病率显著高 (9:1比),特别是在怀孕期间和产前期,并且经常与非传统的危险因素有关.
研究的目的:
- 为了突出SCAD与动脉样硬化冠状动脉疾病相比,SCAD的独特风险因素概况.
- 介绍与SCAD相关的常见非传统风险因素.
- 强调在患有ACS症状的低心血管风险患者,特别是女性中考虑SCAD的重要性.
主要方法:
- 文献综述和分析与SCAD相关的患者数据.
- 识别和分类SCAD的倾向性和沉性因素.
- 对SCAD患者与动脉样硬化冠状动脉疾病患者的风险因素进行比较.
主要成果:
- SCAD在女性中更为普遍,高血压是一个罕见的传统风险因素.
- 常见的相关疾病包括纤维肌力发育不良,遗传性结合组织疾病,怀孕,激素使用,药物滥用和甲状腺疾病.
- 性别之间存在差异,女性更常见的情绪压力和男性更常见的身体压力;焦虑和抑郁症经常被SCAD妇女报告.
结论:
- 应考虑在患有ACS症状和心血管风险低的患者中进行SCAD,特别是在女性中.
- 识别SCAD及其相关的非传统风险因素对于及时诊断和管理至关重要.
- 男性和女性SCAD临床表现和风险因素的差异需要进一步调查.
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