在稳定冠状动脉疾病的皮肤冠状动脉干预后急性四肢缺血
Monil Majmundar1, Wan-Chi Chan1, Vivek Bhat2
1Department of Cardiovascular Medicine University of Kansas Medical Center Kansas City KS USA.
Journal of the American Heart Association
|April 23, 2025
概括
急性四肢缺血 (ALI) 是一种罕见但严重的并发症,在稳定冠状动脉疾病患者的皮肤冠状动脉干预 (PCI) 后出现. 周围动脉疾病显著增加ALI风险,导致较高的死亡率和截肢率.
科学领域:
- 心血管干预 心血管干预
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 经皮冠状动脉干预 (PCI) 治疗稳定的冠状动脉疾病后的急性四肢缺血症 (ALI) 是严重的,但研究不足.
- 关于该患者群体中ALI发生率,预测因子和结果的数据有限.
研究的目的:
- 确定稳定冠状动脉疾病患者PCI后ALI的发生率和预测因素.
- 为了评估与ALI相关的结果在这个队列.
主要方法:
- 分析全国再接收数据库 (2016-2020年) 针对正在接受PCI治疗的患者,以治疗稳定的冠状动脉疾病.
- 使用国际疾病分类第十次修订,临床修改 (ICD-10-CM) 代码识别ALI病例.
- 统计分析以确定ALI预测因子和相关风险.
主要成果:
- 共有629,656名患者接受了PCI;3,456名 (0.55%) 患有ALI.
- 周围动脉疾病是PCI后ALI最强的预测因素 (OR, 53.03).
- ALI患者面临着增加的住院死亡率 (1.6倍) 和重大截肢风险 (4.7倍).
- 栓塞切除与更高的死亡率有关,而血栓溶解与更高的截肢率相关.
结论:
- ALI是稳定的冠状动脉疾病中PCI的罕见但高风险并发症.
- 周围动脉疾病是PCI后ALI发展的关键预测因素.
- ALI显著增加了死亡和肢体截肢的风险.
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