冠状动脉疾病患者及其相关心血管死亡风险的生物心理社会现象组
medRxiv : the preprint server for health sciences
|November 19, 2025
概括
这项研究确定了四个不同的冠状动脉疾病 (CAD) 患者组,揭示了心脏自主功能障碍和缺血性心肌病显著增加死亡风险. 这些发现凸显了个性化CAD管理策略的必要性.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 稳定的冠状动脉疾病 (CAD) 患者表现出不同的临床特征,影响预后.
- 在稳定的CAD患者中,心理社会,代谢和心血管因素各不相同.
- 了解患者异质性对于预测心血管疾病 (CVD) 结果至关重要.
研究的目的:
- 在稳定的CAD患者群体中识别不同的临床现象组.
- 评估已识别的现象组与死亡风险 (特定于心血管疾病和所有原因) 之间的关联.
- 为稳定的CAD提供个性化治疗策略的信息.
主要方法:
- 从949名稳定的CAD参与者收集数据.
- 应用基于模型的聚类,使用自主功能障碍,心理社会负担,心肌损伤,心肌功能障碍和血压的标志物.
- 估计的危险比率 (HRs) 用于确定现象组与死亡率之间的关联.
主要成果:
- 确定了四个不同的现象群,具有不同的社会人口统计和临床特征.
- 现象组1 (心脏自主功能障碍) 和3 (缺血性心肌病) 与低风险组相比,心脏病特异性和全因死亡风险增加了2-10倍.
- 现象组4 (高心理社会负担) 呈现出非显著的死亡风险增加 (1.4-2.3倍).
结论:
- 稳定的CAD患者中的新型现象组与临床上显著的死亡风险差异有关.
- 结果支持CAD评估和管理的整体方法.
- 个性化治疗,包括行为干预,可能会改善患者的治疗结果.
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