没有标准可修改心血管风险因素和结果的慢性冠状动脉综合征:CLARIFY注册表
Guillaume Roger1, Grégory Ducrocq1,2, Jules Mesnier1,2
1Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.
患有稳定冠状动脉疾病 (CAD) 但没有标准可修改心血管风险因子 (SMuRFs) 的患者在5年内心血管死亡或心肌梗塞的风险显著降低. 这种保护作用在女性中更为明显.
科学领域:
- 心血管医学 心血管医学
- 临床心脏病学 临床心脏病学
- 流行病学 流行病学
背景情况:
- 没有标准可修改心血管风险因子 (SMuRFs) 的患有心肌梗塞 (MI) 的患者可能有不同的结局.
- 之前的报道表明,这些患者的医院死亡率较高,但潜在的长期风险较低.
- 稳定冠状动脉疾病 (CAD) 但没有SMuRFs的患者的长期预后仍然不太了解.
研究的目的:
- 调查稳定冠状动脉疾病 (CAD) 缺乏标准可修改心血管风险因素 (SMuRFs) 的患者的长期临床结果.
- 为了比较SMuRFs和SMuRFs患者之间的5年心血管死亡或非致命心肌梗塞 (MI) 风险.
主要方法:
- 对CLARIFY观察队列的分析,包括来自45个国家的32703名患有稳定的CAD的门诊患者 (2009-2010).
- 基线特征和SMuRFs (糖尿病,脂质失调,高血压,吸烟) 患者和没有SMuRFs的患者之间的5年临床结果的比较.
- 主要结局:五年心血管死亡或非致命性心脏病发作的组合;次要结局:五年全因死亡率和MACE.
主要成果:
- 在拥有完整数据的22,132名患者中,977名 (4.4%) 没有SMuRF.
- 没有SMuRF的患者表现出5年内心血管死亡或非致命性MI (5.43%对比7.68%,P=0.012),所有原因死亡率和MACE的明显较低.
- 随着SMuRF的数量逐渐增加,临床事件发生率逐渐增加,在女性中观察到特别明显的好处.
结论:
- 与那些有风险因素的患者相比,患有稳定的CAD和没有SMuRF的患者在5年内心血管死亡或非致命性MI的风险要低得多.
- 不良心血管结果的风险随着越来越多的SMuRFs而不断升级.
- 这些发现强调了风险因素负担在确定稳定的CAD中长期预后的重要性.
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