自发冠状动脉解剖与同时发生的心室心律失常的医院结果
Min Choon Tan1,2, Yong Hao Yeo3, Qi Xuan Ang4
1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona.
概括
自发冠状动脉解剖 (SCAD) 与腹腔失常 (VA) 导致更糟糕的医院结果,包括更高的死亡率和更长的住院时间. 心力衰竭和慢性肝病是SCAD患者与VA相关的关键因素.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 自发冠状动脉解剖 (SCAD) 是一种冠状动脉壁发生撕裂的情况.
- 心室节律失常 (VA) 可能与SCAD同时发生,但它们对美国医院住院结果的影响尚未得到充分证实.
- 这项研究调查了美国有和没有VA的SCAD患者的结果.
研究的目的:
- 分析SCAD和并发VA患者的住院结果.
- 为了确定与SCAD患者的VA发生相关的因素.
- 为管理高风险人群提供见解.
主要方法:
- 利用全国再接收数据库 (2017-2020年) 对患有SCAD的18岁以上患者.
- 在住院期间将患者分为VA和没有VA的组.
- 进行加权,单变量和多变量分析以评估结果和相关因素.
主要成果:
- 患有VA的SCAD患者 (13.5%) 的早期死亡率明显高 (10.2%对2.0%),长时间住院 (33.1%对11.7%),非家庭出院 (21.2%对5.9%).
- 退伍军人与更长的住院时间 (7.39 vs 3.58天) 和更高的住院费用 (31,451美元 vs 13,802美元) 相关.
- 患有VA的SCAD患者的不良事件增加包括心力衰竭,心脏骤停,心脏性休克和急性损伤. 对VA的独立因素是慢性肝病和心力衰竭.
结论:
- 在SCAD患者中,心室心律不整与显著较差的住院结果有关.
- 心力衰竭和慢性肝病被确定为SCAD患者VA发生的独立风险因素.
- 这些发现凸显了SCAD患者对VA的监测的重要性,特别是那些先前患有心力衰竭或肝病的人.
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