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在接受过导管大动脉置换的老年人中,骨质疏松症和死亡率
Pablo Solla-Suarez1,2,3, Saleena Gul Arif1,4, Fayeza Ahmad1
1Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Québec, Canada.
JAMA cardiology
|May 15, 2024
概括
骨髓缩症是一种肌肉和骨衰退的疾病,在接受过导管大动脉置换 (TAVR) 的患者中,显著增加了一年死亡风险. 通过CT扫描进行早期检测可以改善风险评估,并为脆弱的老年人提供指导干预措施.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 骨髓缩症是一种新兴的老年综合征,涉及与年龄相关的肌肉和骨恶化.
- 虚弱和肉在透导管大动脉置换 (TAVR) 患者中是相关的,但骨质肉在这个人群中仍未得到充分研究.
研究的目的:
- 为了研究 osteosarcopenia 和 TAVR 患者的不良结果之间的关联.
- 评估骨质沙症在TAVR后死亡率和残疾的预测价值.
主要方法:
- 对FRAILTY-AVR前性多中心队列研究和麦吉尔扩展 (2012-2022) 的后期分析.
- 包括接受TAVR的70岁以上的患者.
- 使用TAVR前的CT扫描来测量psoas肌肉面积 (PMA) 和脊椎骨密度 (VBD) 定义了骨质疏松症.
- 主要结局:1年全因死亡率. 二次结果:30天死亡率,住院,处置和残疾.
主要成果:
- 15%的患者 (91/605) 患有骨质,以低PMA和低VBD为特征.
- 骨质疏松症与基线较高的虚弱,骨折和营养不良率有关.
- 患有骨髓缩症的患者在1年内死亡率最高 (32%),相比之下,患有孤立的低PMA (14%),孤立的低VBD (11%),或正常的骨和肌肉状况 (9%).
- 骨髓缩症独立预测了一年死亡率 (OR, 3.18) 和残疾恶化 (OR, 2.11).
结论:
- 通过TAVR前CT扫描发现的骨髓缩症与1年死亡率增加三倍有关.
- 这种机会性评估可以提高对脆弱的TAVR患者的风险预测.
- 研究结果支持使用骨髓缩症查来指导康复和临床决策.
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