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接受皮肤冠状动脉干预的移植患者的临床结果
Wayne C Zheng1, Nicole Evans1, Diem Dinh2
1Department of Cardiology, Alfred Health, Melbourne, Vic, Australia.
Heart, lung & circulation
|April 2, 2024
概括
接受皮肤冠状动脉干预 (PCI) 的移植 (RT) 患者比透析患者有更好的短期结果,但长期死亡风险更高. 结局类似于慢性病 (CKD) 患者的短期结局.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
背景情况:
- 接受皮肤冠状动脉干预 (PCI) 的移植 (RT) 患者的临床结果尚不清楚.
- PCI是冠状动脉疾病的常见手术,但患有不同阶段功能的患者群体可能会有不同的结果.
研究的目的:
- 将接受PCI的RT患者的临床结果与透析患者和慢性病患者的临床结果进行比较.
- 在这些不同的患者群体中评估PCI后的短期和长期不良事件.
主要方法:
- 2014年至2021年期间,澳大利亚注册局对17912名接受PCI的患者进行了多中心分析.
- 研究对比了三个组:RT接受者 (n=226),透析患者 (n=992) 和CKD患者 (eGFR 3060毫升/分钟每1.73平方米,n=15,534).
- 主要结局是30天的主要心脏和脑血管不良事件 (MACCEs),包括死亡率,心肌梗塞,支架血栓,目标血管再血管和中风.
主要成果:
- 接受RT的人年轻,不太可能患有严重的左心室功能障碍,但更有可能出现急性冠状动脉综合征,包括STEMI.
- 与透析组 (11.6%) 相比,RT和CKD组的30天MACCE率较低 (4.4%和6.8%).
- 对于RT和CKD组,三年生存率相似,但对于透析患者来说较低. 透析独立预测了30天的MACCE,而RT没有. 无论是RT还是透析都增加了长期死亡风险.
结论:
- 与透析患者相比,接受脏移植的患者在PCI后表现出更有利的短期结果.
- 虽然短期结果与CKD患者相似,但RT接受者在PCI后面临着显著增加的长期死亡风险.
- 这些发现强调了风险分层和长期监测对接受PCI的RT患者的重要性.
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