慢性冠状动脉综合征患者的患者之旅与/或没有阻塞性冠状动脉
Sarena La1,2,3, Rosanna Tavella1,2,3, Jing Wu1
1School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.
患有胸痛且没有阻塞性冠状动脉疾病 (ANOCA) 的患者有与阻塞性冠状动脉疾病 (CAD) 患者相似的症状,但在血管造影后面临着显著的诊断和治疗差距.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 患者的治疗结果.
背景情况:
- 建立了阻塞性冠状动脉疾病 (CAD) 的管理途径.
- 由于有限的数据,没有阻塞性冠状动脉疾病 (ANOCA) 的心痛患者的临床和诊断过程尚不清楚.
研究的目的:
- 为了比较ANOCA患者与阻塞性CAD患者的临床表现,诊断评估和12个月患者报告的结果措施 (PROMs).
- 在ANOCA中评估三年复合重大不良心血管事件 (MACE) 与阻塞性CAD患者.
主要方法:
- 使用了来自南澳大利亚冠状动脉图谱数据库 (CADOSA) 注册表的数据.
- 包括2,285名ANOCA患者和4,087名阻塞性CAD患者在2012-2018年期间.
- 对比临床表现,诊断工作,PROM和MACE.
主要成果:
- 在血管造影前,ANOCA和阻塞性CAD患者有不可分辨的胸痛和缺血性标志物.
- ANOCA患者年轻,更有可能是女性,心脏风险因素较少.
- 血管造影后,ANOCA患者接受心脏诊断或抗心血管治疗的可能性较低,尽管心血管炎的持续率相似.
结论:
- 在血管造影前的临床表现和ANOCA和阻塞性CAD的诊断标记是相似的.
- 在侵袭性冠状动脉血管造影后,ANOCA患者存在显著的诊断和治疗差距.
- 解决这个差距对于改善ANOCA患者的护理至关重要.
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