在患有"稳定"不稳定性胸痛的患者中,血管静脉狭窄的进展和冠状动脉事件
L Chen1, M R Chester, S Redwood
1Department of Cardiological Sciences, St George's Hospital Medical School, London, England.
Circulation
|May 1, 1995
概括
在不稳定的胸痛患者中,复杂的冠状动脉病变经常在医疗稳定下进展,导致心脏事件的风险增加. 这凸显了对这些不稳定的冠状动脉病变进行仔细监测的需要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 最近的研究将血管学复杂的冠状动脉狭窄症与短期的不良结果联系起来.
- 对通过药物治疗稳定的不稳定性胸痛患者的影响尚不清楚.
研究的目的:
- 为了前性地评估冠状动脉狭窄症在不稳定性胸痛患者中进展的进展,这些患者在医疗治疗中得到稳定.
- 为了确定这个患者群体中复杂的冠状动脉病变是否与随后的狭窄症进展和不良事件有关.
主要方法:
- 对85名不稳定的心痛患者进行前性研究,在医疗稳定后需要进行血管塑性手术.
- baseline 和 8 个月 +/- 4 个月的冠状动脉血管学.
- 与缺血相关的狭窄症被分类为"复杂" (边缘不规则,悬浮的边缘,血栓) 或"光滑".
- 自动边缘检测用于评估狭窄的进展 (直径减少>或=20%,或新的完全封闭).
主要成果:
- 在其他的研究中,与缺血相关的狭窄症的25%进展,而与缺血无关的狭窄症的7%相比 (P = .001).
- 复杂的狭窄症的进展率明显高 (34%),比平滑的病变 (10%) (P = .02).
- 在56%的病例中,与缺血相关的狭窄症的进展与随后的冠状动脉事件有关.
结论:
- 冠状动脉狭窄症的进展和不良事件在医疗稳定不稳定的胸痛患者中很常见.
- 复杂的冠状动脉病变经常没有稳定,并且继续进展,构成未来心脏事件的风险.
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