阻塞性睡眠呼吸暂停综合征在慢性全闭性皮肤通道冠状动脉干预中;来自PROGRESS-CTO注册表的见解
Ozgur Selim Ser1, Deniz Mutlu1, Michaella Alexandrou1
1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA.
概括
患有阻塞性睡眠呼吸暂停综合征 (OSAS) 的患者经历慢性全闭症 (CTO) 皮肤冠状动脉干预 (PCI) 有更复杂的病例,但类似的程序成功. 然而,OSAS患者面临更高的重大心脏不良事件和术后死亡风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停综合征 (OSAS) 是一种普遍的疾病,经常与心血管疾病并存.
- 慢性全塞 (CTO) 穿皮冠状动脉干预 (PCI) 是一种复杂的程序,用于治疗具有挑战性的冠状动脉阻塞.
研究的目的:
- 研究诊断为OSAS的患者中CTO PCI的程序结果和长期结果.
- 为了比较CTO PCI在患有和没有OSAS的患者之间的特征和临床结果.
主要方法:
- 一项多中心注册表研究分析了2012年至2024年期间执行的7408个CTO PCI的数据.
- 患者被分为两组:患有OSAS (942名患者) 和没有OSAS的患者.
- 程序的成功,住院并发症和随访结果,包括主要不良心脏事件 (MACE) 和死亡被比较.
主要成果:
- 患有OSAS的患者呈现出更多的并发症和更高的J-CTO和PROGRESS-CTO得分,表明更复杂的CTO.
- 对于CTO PCI的技术和程序成功率在OSAS和非OSAS组之间是相似的 (约为87%).
- 尽管周围手术安全性相似,但OSAS患者的随访MACE (3.9%对1.6%) 和死亡 (2.6%对0.6%) 率显著更高.
结论:
- 阻塞性睡眠呼吸暂停综合征经常在接受CTO PCI的患者中观察到.
- 虽然CTO PCI在OSAS患者的周边过程期间是技术上可行的和安全的,但在随访期间,他们表现出更高的不良事件风险.
- 在CTO PCI之后,OSAS是MACE增加的独立预测器,突出了对综合管理策略的需求.
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