出血风险和炎症对皮肤冠状动脉干预后心血管结果的影响
Manish Vinayak1, Davide Cao2, Richard Tanner1
1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC. Cardiovascular interventions
|February 14, 2024
概括
高灵敏度C反应蛋白 (hsCRP) 的升高表明经皮肤冠状动脉干预 (PCI) 后心血管不良事件的风险较高,不论出血风险如何. 在接受PCI的患者中,hsCRP水平无法预测出血并发症.
科学领域:
- 心脏病学 心脏病学
- 炎症研究 炎症研究
- 干预心脏病学 干预心脏病学
背景情况:
- 像高灵敏度C反应蛋白 (hsCRP) 这样的系统性炎症标志物与皮肤冠状动脉干预 (PCI) 后的心血管不良事件有关.
- 高出血风险 (HBR) 对PCI后hsCRP与心血管结果之间的关联的影响尚不清楚.
研究的目的:
- 研究hsCRP水平对接受PCI的患者心血管结果的影响.
- 根据高出血风险 (HBR) 条件的存在或不存在来分层结果.
主要方法:
- 分析了一组15150名在2012年至2019年期间接受PCI的患者,基线hsCRP测量.
- 高hsCRP被定义为>3 mg/L;HBR是使用学术研究联盟标准来确定的.
- 主要终点是1年内发生的重大不良心血管和脑血管事件 (MACCE);出血事件是次要结果.
主要成果:
- 患有高hsCRP的患者在HBR (aHR: 1.49) 和非HBR (aHR: 1.87) 亚组中表现出持续较高的MACCE风险,没有显著的相互作用.
- 虽然在HBR队列中出血风险更高,但hsCRP水平在HBR (aHR: 1.04) 或非HBR (aHR: 0.99) 组中没有预测出血事件.
- 对于MACCE或出血结果,没有观察到HBR状态和hsCRP水平之间的显著相互作用.
结论:
- 在PCI时hsCRP水平升高与缺血事件的风险增加有关.
- 这种hsCRP与缺血风险之间的关联无论患者的高出血风险状况如何,都会持续存在.
- 在接受PCI的患者中,hsCRP似乎不是出血并发症的预测因素.
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