慢性冠状动脉全封闭的患病率和预后影响
Michael Behnes1, Moritz Schmidberger1, Giuseppe Vadalà2
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Baden-Württemberg, Germany.
概括
慢性冠状动脉完全闭塞 (CTO) 在心脏性休克 (CS) 患者中很常见,并且独立预测了更高的30天死亡率. 确定CTO对于改善CS的结果至关重要.
科学领域:
- 心脏病学
- 重症监护医疗
- 干预心脏病学
背景情况:
- 尽管进行了先进的治疗,心脏性休克的死亡率仍然很高.
- 鉴定CS患者的预后因素对于改善存活率至关重要.
- 慢性冠状动脉全闭症 (CTO) 对冠状动脉病患者的预后影响需要研究.
研究的目的:
- 研究慢性冠状动脉完全闭塞 (CTO) 对心脏性休克 (CS) 患者的预后影响.
- 确定CTO存在与CS患者全因死亡率的增加有关.
主要方法:
- 包括从2019年至2021年接受入侵性冠状动脉血管学 (ICA) 的连续患者.
- 与没有CTO的患者之间的30天全因死亡风险比较.
- 根据冠状动脉疾病 (CAD) 的程度进行风险分层.
主要成果:
- 在CS患者中,有24%至少有一次CTO.
- 与30天全因死亡率显著上升 (70.2%对47.6%;HR=1. 783) 相关.
- 在多变量调整 (aHR=1. 898) 和多血管CAD患者 (aHR=1. 723) 后,CTO仍然是死亡率的独立预测因素.
结论:
- 在CS患者中冠状动脉CTO是普遍存在的.
- 在CS患者中,CTO是30天全因死亡率的独立预测指标.
- 这些发现凸显了在CS管理中评估CTO的重要性.
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