在膜手术患者中,对于中间冠状动脉狭窄症的功能性不完全再血管化的预后价值
Jinying Zhou1,2,3, Wei Gao1,2,3, Wenshuo Wang4
1Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
概括
在中级冠状动脉狭窄症的膜手术后的功能性不完全重血管化 (ICR) 增加了主要的不良心脏事件. 评估中间冠状动脉狭窄功能对于指导重血管化决策至关重要.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 心脏成像 - - 心脏成像
背景情况:
- 中间冠状动脉狭窄 (50%-70%) 在接受初级膜手术的患者中构成了管理挑战.
- 在这个特定的患者队列中,功能性不完全重血管化的 (ICR) 预后意义仍在调查中.
研究的目的:
- 评估功能性ICR对接受初级膜手术的中级冠状动脉狭窄症患者主要不良心脏结果 (MACE) 的影响.
- 为了确定中级冠状动脉狭窄的功能性评估是否会影响临床结果.
主要方法:
- 在486名接受了中级冠状动脉狭窄 (50%-70%) 的门手术的患者进行了回顾性队列研究.
- 用量流量储备 (μQFR) 定义的功能性ICR ≤0.8 在非绕过的容器中.
- MACE被定义为所有原因的死亡,心肌梗塞,无计划的再血管化或中风.
主要成果:
- 17.7%的患者在手术后有功能性ICR.
- 在3.4年的随访期间,MACE的发病率为14.2%.
- 功能性ICR与MACE (调整HR 1.78) 和再血管化 (调整HR 4.69) 的风险显著增加有关.
结论:
- 在初级膜手术中中期冠状动脉狭窄的功能性ICR与MACE风险增加有关.
- 建议对中级冠状动脉狭窄的功能性评估作为心肌重血管化策略的指导.
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