在50岁以上的患者中重复冠状动脉血管检查,先前的冠状动脉血管检查结果正常/非阻塞性 - - 来自回顾性研究的见解
Ariel Roguin1, Ofer Kobo1, Simha-Ron Meisel1
1Department of Cardiology, Hillel Yaffe Medical Center, Affiliated to the Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Hadera 3200003, Israel.
Journal of clinical medicine
|February 10, 2024
概括
冠状动脉扫描显示非阻塞性冠状动脉疾病 (NOCAD) 是常见的. 重复血管造影通常是不必要的,特别是在无症状患者中,并且应保留给具有阳性热素结果的患者.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 预防性心脏病学 预防性心脏病学
背景情况:
- 在接受冠状动脉扫描 (CAG) 的患者中,很大一部分患有正常或非阻塞性冠状动脉疾病 (NOCAD).
- 在NOCAD患者50岁以上的患者中,长期结果和再导管率尚未确定.
研究的目的:
- 评估NOCAD患者50岁以上的重复导管治疗的发生率和长期结果.
- 确定重复CAG的预测因素,并评估重复程序的适当性.
主要方法:
- 50岁以上的NOCAD患者的回顾性分析,他们在2008-2019年期间接受了他们的第一个CAG.
- 评估基线特征,风险因素,CAG指示和重复CAG的结果.
- 在接受重复手术的患者中对药物治疗的评估.
主要成果:
- 在1939名NOCAD患者中,90%的人没有重复CAG.
- 在10%的患者中进行了重复CAG;7%的患者进行了徒劳的手术,3%的患者进行了血管造形手术.
- 与重复CAG相关的因素包括男性性别,肥胖,高血压,糖尿病,吸烟,心脏动和高脂血症. 85%的干预组使用的他类药物/阿司匹林水平低于最佳水平.
结论:
- 非阻塞性冠状动脉疾病是常见的发现.
- 重复血管造影的门应该更高,主要是对于热素阳性病例.
- 患有NOCAD的患者需要基于风险配置的管理,而不是单次阴性血管造影的虚假保证.
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