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常规的炎症指数改变了通过皮肤进行冠状动脉干预的患者中与克隆造血相关的预后风险:现实世界的队列研究

Xuxiang Shen¹, Ying Song², Hangyi Zhao¹

¹Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

|February 26, 2026

概括

克隆性血液形成 (CHIP) 增加了皮肤穿透冠状动脉干预 (PCI) 后患者的死亡风险,特别是在高度炎症的情况下. 管理炎症可能会改善CHIP的PCI患者的结果.

科学领域:

心血管医学心血管医学
血液学血液学血液学
遗传学是一个遗传学.

背景情况:

接受皮肤冠状动脉干预 (PCI) 的患者面临显著的残留炎症风险.
不确定潜力的克隆性血液形成 (CHIP) 是动脉生成中的一种新型的促炎因素.
在二次PCI预防中,CHIP,炎症和预后之间的相互作用需要进一步研究.

研究的目的:

研究CHIP和全身炎症对PCI后患者预后的综合影响.
评估CHIP,炎症标志物和PCI患者的长期不良结果之间的关联.

主要方法:

分析了3640名接受标准治疗的PCI患者队列.
使用向测序识别CHIP突变.
系统性炎症通过12个常规炎症指数进行评估.
考克斯的比例危险模型评估了CHIP和炎症对5年全因死亡率和主要心脏和脑血管不良事件 (MACCE) 的影响.

主要成果:

在21.95%的PCI患者中发现了CHIP,并且独立地与所有原因和心脏病死亡率的增加有关.
系统性炎症水平 (例如,SII,SIRI) 显著改变了CHIP和死亡率之间的关联.
在低炎症状态下,CHIP没有增加死亡风险,但在炎症升高时,风险显著增加.
将CHIP纳入GRACE分数中略有改善了PCI后的长期死亡预测.

结论:

与血液形成相关的基因变异,如CHIP,会增加预后风险,特别是当与系统性炎症增加同时发生时.
管理炎症负担可能对患有CHIP的PCI患者有益.
在PCI患者中,CHIP是显著的风险因素,特别是当炎症存在时.

关键词:

克隆性血液形成 (clonal hematopoiesis) 是一种血液形成的过程.炎症指数炎症指数修改效应是一种修改效应.通过皮肤进行冠状动脉干预.预测预后预测预测

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