当代穿皮冠状动脉干预后的残留炎症风险和临床结果:系统性审查和元分析
Francisco José Romeo1, Michele Golino2,3, Matteo Morello3,4
1Department of Cardiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, 1120 NW 14th St, Miami, FL, 33136, USA. fjr62@miami.edu.
Scientific reports
|February 11, 2026
概括
高残留炎症风险 (RIR),PCI后hsCRP水平升高表明,显著增加重大心血管不良事件的风险和高风险患者的死亡率. 这一发现凸显了针对性抗炎疗法的必要性.
科学领域:
- 心脏病学 心脏病学
- 炎症研究 炎症研究
- 干预心脏病学 干预心脏病学
背景情况:
- 升高的低密度脂蛋白胆固醇 (LDL-C) 和亚临床炎症 (hsCRP) 是动脉样硬化的主要驱动因素.
- 高风险患者经常表现出残留风险,包括残留炎症风险 (RIR),尽管最佳的医疗治疗.
- 穿皮冠状动脉干预 (PCI) 是一种常见的治疗冠状动脉疾病的程序.
研究的目的:
- 研究残留炎症风险 (RIR) 对同时接受PCI的患者心血管结局的影响.
- 评估PCI后持续高RIR和主要不良心血管事件 (MACE) 之间的关联.
主要方法:
- 在主要数据库 (PubMed,EMBASE,Cochrane,MEDLINE) 进行了系统的文献搜索,直到2024年12月.
- 包括的研究集中在接受PCI的冠状动脉疾病患者身上,通过基线和随访 (>4周间隔) 的hsCRP测量来评估炎症负担.
- 高RIR被定义为hsCRP≥2 mg/L在1个月的随访;元分析使用随机效应模型来计算风险比率 (RR) 和95%置信区间 (CI).
主要成果:
- 分析了5项涉及13,604名患者的研究,其中5,833名患者在PCI后30天被确定具有高RIR.
- 持续高的RIR与MACE的风险增加显著相关 (RR=1.64,95% CI 1.33-2.03).
- 高RIR还与较高的全因死亡率相关 (RR=3.25,95% CI 2.49-4.25),非致命的心肌梗塞 (RR=1.46,95% CI 1.00-2.12),以及非致命性中风 (RR=1.64,95% CI 1.14-2.37).
结论:
- 在接受当代PCI的患者中,高残留炎症风险是心血管不良结果的重要预测因素.
- 这些发现强调了监测和管理高风险心血管疾病患者的RIR的重要性.
- 结果表明,针对性抗炎和降脂疗法可能对PCI后持续高RIR患者有益.
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