功能障碍对接受冠状动脉血管检查的未经选择的患者的预后影响:在哪些子组中功能障碍很重要?
Philipp Steinke1, Ibrahim Akin1, Lasse Kuhn1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany.
Journal of clinical medicine
|June 13, 2025
概括
经过冠状动脉血管造影的功能受损患者面临心力衰竭再住院的更高风险. 这种风险在具有较低EGFR水平的人群中显著增加,即使在调整后也是如此.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
背景情况:
- 人口变化和改善的心血管疾病治疗方法改变了接受冠状动脉血管学 (CA) 的患者个人资料.
- 关于功能障碍对结果的影响的数据有限,根据CA表示分层分层.
研究的目的:
- 评估不同功能水平的患者冠状动脉疾病 (CAD) 的患病率和程度.
- 检查功能障碍对心力衰竭 (HF),急性心肌梗塞 (AMI) 的再住院风险以及CA后需要再血管化的长期影响.
主要方法:
- 分析了2016年至2022年间连续接受入侵性CA的患者.
- 基于估计的淋巴细胞过率 (eGFR) 水平的患者分层.
- 评估CAD患病率,程度和36个月的随访结果,包括HF再住院,AMI和再血管.
主要成果:
- 总共有7624名患者被纳入,其中7.3%的eGFR<30mL/min/1.73m2,29.0%的eGFR为30-60mL/min/1.73m2,63.7%的eGFR≥60mL/min/1.73m2.
- 较低EGFR (<60毫升/分钟/1.73米2) 的患者表现出较高的CAD和三血管CAD患病率 (p=0.001).
- 功能障碍 (eGFR <60 mL/min/1.73 m2) 与36个月的高频率相关再住院和AMI的显著更高风险相关 (p=0.001),在多变量调整后仍然存在.
结论:
- 功能障碍显著增加了36个月高频率相关再住院的风险,即使在多变量调整后.
- 在EGFR<30mL/min/1.73m2的患者中,HF再入院的风险特别高,这些患者还具有不补偿的HF和LVEF<35%.
- 在EGFR 30-60 mL/min/1.73 m2的患者中,胸痛和多血管疾病进一步增加了与HF相关的再住院的风险.
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