大动脉狭窄症的严重程度和症状状况与发病率和死亡率的关联
Matthew D Solomon1, Alan S Go2, Thomas Leong3
1Center for Health Systems Research, Sutter Health, Emeryville, California, USA; Division of Cardiology, California Pacific Medical Center, Sutter Health, San Francisco, California, USA.
JACC. Advances
|July 22, 2025
概括
症状状态,而不仅仅是大动脉狭窄症 (AS) 严重程度,是不良结果的关键风险因素. 早期干预可能有利于具有AS症状的高风险患者.
科学领域:
- 心脏病学 心脏病学
- 临床结果研究研究
- 医疗信息学 医疗信息学
背景情况:
- 大动脉狭窄症 (AS) 严重程度,症状和患者结局之间的相互作用仍然不清楚.
- 了解这种关系对于有效的患者管理至关重要.
研究的目的:
- 调查诊断时潜在的AS相关症状与临床结果之间的关联.
- 根据症状状况和AS严重程度,评估死亡和AS相关住院的风险.
主要方法:
- 来自大型医疗保健系统的4万多名AS成年人的回顾性队列研究.
- 利用自然语言处理 (NLP) 在心声回声图报告和诊断代码上识别AS严重程度和症状.
- 应用了考克斯模型来分析症状,AS严重程度和结果之间的关联,平均随访时间为2.2年.
主要成果:
- 在所有严重程度 (轻度至重度) 的AS患者中,高比例的患者经历了症状.
- 症状患者年龄较大,女性更常见,并具有较高的并发症负担.
- 症状状态独立预测风险;有症状的中度AS患者面临与无症状的严重AS患者相似的风险.
结论:
- 症状状态是主动脉狭窄的不良结果的关键预测因素,独立于疾病严重程度.
- 进一步的研究是有必要的,以探索早期干预策略对症状AS患者的好处.
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