患有非阻塞性冠状动脉疾病的患者的预后分层根据侵入性冠状动脉功能测试进行管理
Eva Rumiz1, Georgina Fuertes2, Ainhoa Pérez3
1Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Universitat de València, Valencia, Spain; Servicio de Cardiología, Hospital QuironSalud, Valencia, Spain.
Revista espanola de cardiologia (English ed.)
|November 27, 2025
概括
与非阻塞性冠状动脉疾病 (ANOCA/INOCA) 患有心痛或心肌缺血的患者根据其内型有不同的预后. 微血管功能障碍与更高的心血管不良事件风险有关,即使有量身定制的治疗.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 翻译研究是翻译研究.
背景情况:
- 与非阻塞性冠状动脉疾病 (ANOCA/INOCA) 相结合的胸痛或心肌缺血是一个诊断挑战,并与不良结果相关.
- 了解不同ANOCA/INOCA内型的预后影响对于指导患者管理至关重要.
研究的目的:
- 通过侵入性冠状动脉功能测试 (CFT) 识别的内型分层的ANOCA/INOCA患者的长期预后.
- 为了确定基于内型的量身定制治疗是否会影响患者的结果.
主要方法:
- 一项前性多中心观察性研究,涉及308名接受侵袭性CFT的ANOCA/INOCA患者.
- 患者被分为四种末端类型:微血管功能障碍,心上,微血管和负-CFT.
- 主要结局是心肌梗塞,胸痛急诊室访问或心痛/心力衰竭住院的综合结果,使用负二项回归分析.
主要成果:
- 在长达1.8年的中位数随访期间,观察到综合结局发病率在内型之间有显著差异 (P < .001).
- 微血管功能障碍显示了最高的不良事件发病率 (35.3每100个患者年).
- 多变量分析确定了微血管功能障碍是复合结果的唯一独立预测因素 (IRR,3.24;P=.029).
结论:
- 在ANOCA/INOCA患者的内型分类显示出不同的预后轨迹,尽管有量身定制的医疗治疗.
- 微血管功能障碍代表了一种高风险的内型,与重复性心血管事件的更大负担有关.
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