没有ST段升高的肌肉梗塞的非罪祸首脆弱斑块和预后:一项PROSPECT II子研究
Pernille G Thrane1,2, Michael Maeng1,2, Akiko Maehara3,4
1Department of Cardiology, Aarhus University Hospital, Denmark (P.G.T., M. Maeng, H.E.B.).
Circulation
|June 23, 2025
概括
在ST升高心肌梗塞 (STEMI) 和非STEMI (NSTEMI) 患者中,高风险斑块的患病率相似. 未经治疗的非致病病变的结果也相似,这表明两组患者的复血管化策略相似.
科学领域:
- 心脏病学
- 干预心脏病学
- 血管生物学
背景情况:
- 在ST升高心肌梗塞 (STEMI) 和非STEMI (NSTEMI) 的非致病性病变中,临床指导方针不同.
- 高危易受损斑块的患病率及其对STEMI与NSTEMI结果的影响尚不清楚.
研究的目的:
- 在STEMI和NSTEMI患者中比较未经治疗的高风险易受损伤的患病率.
- 在这两组患者中评估与这些非致病病变相关的长期结果.
主要方法:
- 在PROSPECT II研究中,有898名近期心肌梗塞患者接受了三血管血管检查.
- 近红外光谱和血管内超声检测发现了两种特征的高风险斑块 (斑块负荷≥70%和脂质核心负荷指数≥324.7).
- 从未治疗的非致病病变引起的重大心血管不良事件 (MACE) 的中位数为3. 7年.
主要成果:
- 在病变水平上,两种特征高风险斑块的患病率略高于STEMI (12. 8%) 与NSTEMI (10. 1%),但在患者水平上相似 (38. 8% 与32. 7%).
- 在STEMI和NSTEMI组中,至少一个符合高风险标准的斑块的患病率也相似.
- 在STEMI和NSTEMI患者中,非致病性MACE (8. 6%与7. 8%) 和所有MACE (14. 2%与13. 0%) 的四年率相似.
结论:
- 在STEMI和NSTEMI中,高风险易受损伤的每位患者的患病率相似.
- 在STEMI和NSTEMI中,主要心血管不良事件的长期发病率相似.
- 这些发现支持在STEMI和NSTEMI患者的非罪祸首病变后进行类似的重血管化策略.
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