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复杂和高风险的皮肤冠状动脉干预后的临床结果根据基线慢性病慢性病
Francesca Maria Di Muro1,2, Samantha Sartori1, Birgit Vogel1
1Icahn School of Medicine at Mount Sinai, Mount Sinai Fuster Heart Hospital, New York, NY, USA.
概括
慢性病 (CKD) 显著增加了主要不良心血管事件 (MACE) 和复杂高风险皮肤冠状动脉干预 (CHIP) 后出血的风险. 慢性病还会使术后与对比相关的急性损伤 (CA-AKI) 的风险增加一倍.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 干预心脏病学 干预心脏病学
背景情况:
- 慢性病 (CKD) 与冠状动脉疾病 (CAD) 患者进行皮肤冠状动脉干预 (PCI) 的不良结果有关.
- 在复杂高风险PCI (CHIP) 患者中,CKD的预后影响以前是未知的.
研究的目的:
- 调查CKD与CHIP患者的结局之间的关联.
- 评估CHIP患者患有慢性脏病的主要不良心血管事件 (MACE),出血和与对比相关的急性损伤 (CA-AKI) 的风险.
主要方法:
- 分析了2012年至2022年期间接受治疗的4855名CHIP患者的队列.
- 根据CKD状态 (eGFR <60毫升/分钟/1.73米2) 患者被分层.
- 用多变量考克斯回归调整风险因素和并发症来评估结果,包括MACE (死亡率,心脏病发作,中风) 和一年后出血.
主要成果:
- 39.6%的CHIP患者患有CKD,随着年龄的增长,出现了更多的并发症和复杂的CAD.
- 慢性病与MACE (由死亡率和MI驱动) 和出血的1年风险显著增加有关.
- 虽然医院内缺血和出血事件的发生率相似,但CKD患者的CA-AKI发生率是CA-AKI的两倍.
结论:
- 慢性病是CHIP患者一年后不良缺血和出血事件的强有力的预测因素.
- CKD使程序后CA-AKI的风险增加了一倍,突出了需要专门管理的需要.
- 针对性风险评估和管理策略对于这种患有CKD的高风险CHIP人群至关重要.
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