旁路手术患者的症状早期冠状动脉移植失败:发病率,预测因素和临床影响
Martijn J H van Oort1, Ibtihal Al Amri1, Arend de Weger2
1Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
概括
大多数患者发生了冠状动脉旁路移植手术 (CABG) 后的症状早期冠状动脉移植衰竭 (CGF). 早期的CGF与较高的重大心血管不良事件 (MACE) 发生率有关,尽管存在一些保护因素.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 冠状动脉旁路移植手术 (CABG) 是治疗冠状动脉疾病的常见手术.
- 早期移植失败 (CGF) 可能发生在CABG后,影响长期结果.
- 确定早期CGF的风险因素和临床影响对于患者管理至关重要.
研究的目的:
- 确定症状早期CGF的临床和术后风险因素.
- 评估症状早期CGF对主要心血管不良事件 (MACE) 的长期临床影响.
主要方法:
- 在CABG后 (2012-2022) 进行冠状动脉血管造影 (CAG) 的92名患者的回顾性分析.
- 症状早期的CGF根据CAG的特定标准定义 (缩小,闭塞,血栓,低流量,扭曲).
- 卡普兰-梅尔和多变量分析评估了长达5年的无MACE生存率和CGF预测指标.
主要成果:
- 在59.8%的患者中,有症状的早期CGF存在.
- 症状早期CGF患者在33个月的随访期间显示出明显更高的MACE率 (p=0.023).
- 静脉移植集成 (p=0.005),Y移植配置 (p=0.002) 和长时间的内支持 (p=0.032) 与早期CGF相关.
结论:
- 在CABG后的患者中,症状早期的CGF是常见的,需要预释CAG.
- 早期的CGF与MACE率的增加有关.
- 静脉移植集成,Y移植配置和长时间的内支持是早期CGF的潜在预测因素,需要谨慎的解释.
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