对于心力衰竭患者的手术管理的预后因素,心脏衰竭患者的左心室喷射分数减少
Mahmoud Yousef Ibrahim Abuharb1, Liu Kaiwen1, Huang Zhuhui1
1Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing.
Heliyon
|March 4, 2024
概括
冠状动脉旁路移植 (CABG) 结果对于心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心力衰竭患者的心脏衰竭患者的心脏衰竭患者的心脏衰竭患者的心脏衰竭患者的心脏衰竭患者的心脏衰竭 老年,糖尿病,功能衰竭和之前的PCI增加了CABG后的不良事件.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 血管外科 血管外科
背景情况:
- 冠状动脉疾病 (CAD) 管理包括药物和手术选择.
- 冠状动脉旁路移植 (CABG) 首选用于低射出分数 (EF) 的CAD患者,因为结果更好.
- 减少喷射率 (HFrEF) 的心力衰竭在手术候选人中提出了独特的挑战.
研究的目的:
- 在HFrEF患者中确定与CABG后不良结果相关的因素.
- 为了在这个群体中比较内CABG (ONCAB) 和外CABG (OPCAB) 之间的结果.
- 确定CABG后主要心血管和脑血管不良事件 (MACCE) 的预测因素.
主要方法:
- 500名患有LVEF≤40%的CAD患者进行了回顾性审查,接受了ONCAB或OPCAB.
- 对临床和手术数据的分析,包括术后死亡率,发病率和MACCE.
- 使用单变量和多变量COX回归来识别风险因素.
主要成果:
- 500名患者中有64人 (12.8%) 经历了MACCE.
- 单变量分析确定年龄≥65,糖尿病和功能不全是危险因素.
- 多变量分析将之前的皮肤穿透冠状动脉干预 (PCI) 作为一个显著的风险因素.
结论:
- 年龄,糖尿病,手术前功能衰竭和之前的PCI是HFrEF患者MACCE后CABG的显著预测因素.
- 这些发现有助于对CABG进行风险分层和患者选择.
- 优化手术前条件可能会改善这些高风险患者的治疗结果.
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