探索慢性全闭和冠状动脉疾病死亡率之间的关系
Joakim Sundström1, Mohammed Mohammed1, Antros Louca1
1Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
概括
在冠状动脉疾病中,慢性全闭 (CTO) 的数量和位置显著影响长期存活率. 更多的CTO和像RCA这样的特定地点增加了死亡风险,有助于风险分层.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 公共卫生 公共卫生
背景情况:
- 慢性全闭症 (CTO) 在冠状动脉疾病 (CAD) 中很普遍.
- 已知CTOs会影响存活率,特别是在急性心肌梗塞和心脏骤停时.
- 在更广泛的CAD人群中,CTO对长期生存的影响需要进一步调查.
研究的目的:
- 调查CTO数量,位置和严重程度与长期存活率之间的关联.
- 分析一大批未经选择的CAD患者的长期存活率.
主要方法:
- 从2015年7月至2021年12月的瑞典冠状动脉血管学和血管造形注册表 (SCAAR) 采用了数据.
- 排除了先前经过冠状动脉旁路移植 (CABG) 的患者.
- 根据CTO计数 (无,1,≥2) 和位置 (LAD,LCX,RCA) 分类患者;使用Kaplan-Meier和Cox模型评估生存率.
主要成果:
- 在202,191名患者中,88.0%没有CTO,9.8%有1次CTO,2.1%有≥2次CTO.
- 随着CTO数量的增加,生存率下降 (p < 0.0001).
- 与没有CTO相比,1个CTO的死亡危险比为1.69和≥2个CTO的死亡危险比为2.27;LAD,RCA和LCX的调整HR分别为1.31,1.59和1.28.
结论:
- CTO的存在,数量和解剖位置是CAD患者长期存活的重要决定因素.
- 这些发现支持CTO患者的长期风险分层.
- 这些信息可能有助于提高患者选择重血管化干预的可能性.
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