无阻塞冠状动脉的胸痛患者15年心血管风险
Kevin K W Olesen1, Morten Madsen2, Morten Würtz3
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
JACC. Cardiovascular interventions
|November 15, 2025
概括
与普通人群相比,患有胸痛且没有阻塞性冠状动脉疾病 (ANOCA) 的患者面临类似的心肌梗塞风险,但中风风险略高. 在ANOCA组中,死亡风险较低,年龄和性别影响了结果.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 流行病学 流行病学
背景情况:
- 国际指导方针强调,在患有心肌痛且没有阻塞性冠状动脉疾病 (ANOCA) 的患者中,不良事件的风险增加.
- 转诊进行冠状动脉血管造影的ANOCA患者代表了患有稳定性胸痛的重要人群.
研究的目的:
- 为了评估ANOCA患者的15年心血管风险.
- 为了将这种风险与没有已知的冠状动脉疾病的匹配的普通人群队列进行比较.
主要方法:
- 一项队列研究分析了患有稳定胸痛和没有或轻度冠状动脉疾病的冠状动脉血管造影 (2003-2021) 的患者.
- 结果 (心肌梗塞,缺血性中风,死亡) 与1:5年龄和性别匹配的一般人口队列进行了比较.
- 计算了15年风险差异,考虑竞争性风险;进行了年龄和性别分层分析.
主要成果:
- 与一般人群相比,ANOCA队列 (n=21,132) 的15年心肌梗塞发病率 (3.5%) 与一般人群相比 (n=105,660;3.5%) 呈现出类似的情况.
- 在ANOCA患者中,缺血性中风的风险较高 (3.7%vs2.9%) 和死亡率略低 (25.4%vs26.4%).
- 男人和老年患者 (≥75岁) 与相匹配的一般人群相比,风险最低.
结论:
- 与一般人群相比,ANOCA患者的心肌梗塞风险相似,死亡率较低,缺血性中风风险略有增加.
- 在ANOCA患者中,心血管风险受年龄和性别的影响,需要量身定制的风险评估.
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