对当代中低风险人口中期预后的比较与以指导方针为导向的年龄界限
Stefano Benenati1, Francesco Gallo2, Won-Keun Kim3
1Dipartimento di Medicina Interna e Specialità Mediche (DIMI), University of Genoa, 16126 Genoa, Italy.
Journal of cardiovascular development and disease
|January 26, 2024
概括
通过导管的大动脉植入 (TAVI) 在中低风险患者中显示了类似的结果,不论年龄. 75岁的指导年龄截止值不能预测这些患者的死亡率.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 老年医学 老年医学
背景情况:
- 欧洲指导方针建议在75岁及以上的中低风险患者进行透管大动脉植入 (TAVI).
- 这种年龄切线对TAVI结果的预后价值仍然不清楚.
研究的目的:
- 评估在接受TAVI的中低风险患者中75岁年龄切线的预后相关性.
- 为了比较75岁以下的患者和75岁或以上的患者之间的全因死亡率.
主要方法:
- 来自HORSE注册表的数据分析,包括中低风险患者 (胸部外科医生协会得分<8%).
- 对75岁以下和75岁以上患者的结局进行比较.
- 主要终点:通过日志等级测试和考克斯回归分析评估的全因死亡率.
主要成果:
- 包括2685名患者:280名 (<75岁) 和2405名 (≥75岁).
- 两年龄组之间没有观察到所有原因死亡率的统计学上显著差异 (逻辑等级p = 0.925).
- 年龄,无论是连续的还是75岁时二分化的,都不能预测所有原因的死亡率 (HR1.01,p=0.294和HR0.97,p=0.924).
结论:
- 在中低风险患者中,TAVI在不同年龄组中显示出可比的预后益处.
- 当前指导方针中使用的75岁年龄门不能预测不良事件或中期全因死亡率.
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