根据大动脉狭窄症管理的临床结果:来自现实世界的实践的见解
Augustin Coisne1,2, David Montaigne1, Samy Aghezzaf1
1Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille Lille France.
Journal of the American Heart Association
|November 15, 2024
概括
现实数据显示,许多患有严重的大动脉狭窄症 (AS) 的患者没有接受大动脉置换 (AVR),导致高死亡率. 改善患者教育和共享决策对于优化AS护理至关重要.
科学领域:
- 心脏病学 心脏病学
- 临床结果 临床结果
- 膜心脏疾病 膜心脏疾病
背景情况:
- 对大动脉狭窄症 (AS) 管理临床结果的现实数据有限.
- 这项研究调查了不同程度的AS的门诊患者的长期管理和结果.
研究的目的:
- 评估门诊患者轻度,中度和重度大动脉狭窄的长期临床结果.
- 评估这个队列中大动脉置换 (AVR) 和死亡方式的比率.
主要方法:
- 在VALVENOR研究中,在2016年5月至2017年12月期间,招募了2704名AS (轻度,中度,重度) 门诊患者.
- 随访时间平均为5年,追踪AVR手术和死亡率.
- 还收集了关于不接受AVR (徒劳,拒绝) 的原因的数据.
主要成果:
- 5年后,62.8%的严重AS患者进行了AVR,死亡或AVR的5年复合发病率高 (90.6%).
- 在292名符合条件但未接受治疗的患者中,有137名AVR被认为是徒劳的,155人拒绝AVR.
- 对于未经治疗的严重AS,3年死亡率很高 (86%为徒劳,72.3%为拒绝),主要是心血管,拒绝AVR的人.
结论:
- 三分之二的严重AS患者在5年内接受了AVR,突出显示了治疗的差距.
- 未经治疗的严重AS与大量的死亡率有关,特别是那些AVR下降的患者的心血管死亡.
- 加强患者教育和共享决策对于提高AS护理质量至关重要.
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