多血管疾病严重程度对急性心力衰竭预后的影响
Marlon V Gatuz1, Rami Abu-Fanne1, Dmitry Abramov2
1Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel.
Heart and vessels
|December 1, 2024
概括
患有急性心力衰竭 (AHF) 和多血管疾病的患者面临更糟糕的结果. 增加所涉及的血管床与较高的心血管和脑血管重大不良事件 (MACCE),死亡率和出血风险相关.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多血管疾病在急性心力衰竭 (AHF) 患者中很常见,并且与预后不佳有关.
- 关于血管疾病的程度如何影响AHF的结果的数据有限.
- 了解这种关系对于管理具有多种并发症的AHF患者至关重要.
研究的目的:
- 调查AHF患者患病的血管病床数量与住院结果之间的关联.
- 根据多血管疾病的程度对心力衰竭与减少喷射率 (HFrEF) 和心力衰竭与保存喷射率 (HFpEF) 的结果进行分层.
主要方法:
- 国家住院患者样本 (2016-2019) 分析,包括652,710例成年AHF住院病例.
- 根据患病的血管病床数量分层的患者 (单个 vs 多血管).
- 多变量回归模型评估了医院内主要不良心血管和脑血管事件 (MACCE),死亡率,脑血管事故 (CVA) 和重大出血.
主要成果:
- 超过一半 (57.8%) 的AHF患者患有多血管疾病.
- 患病血管病床数量的增加与年龄的增长相关,并发症负担更高,住院时间更长,医院费用增加.
- 在HFrEF和HFpEF患者中,更高的MACCE,死亡率,CVA和重大出血的几率与更多患病的血管床 (p趋势<0.001) 有显著的关联.
结论:
- 多血管疾病的程度是AHF中不良住院结果的重要预测因素.
- 综合性血管评估和有针对性的干预措施对于改善多血管疾病高风险AHF患者的治疗结果至关重要.
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