选择性冠状动脉干预后肌酸激酶升高的预后影响
T Q Kong1, C J Davidson, S N Meyers
1Department of Internal Medicine, Division of Cardiology, Northwestern University Medical School, Chicago, Ill, USA.
JAMA
|February 12, 1997
概括
皮肤透光冠状动脉血管塑造术 (PTCA) 后肌酸激酶 (CK) 升高表明晚期心脏死亡风险较高. 即使是轻微的CK增加,也表明手术后心脏病死亡风险明显增加.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 干预心脏病学 干预心脏病学
背景情况:
- 皮肤透光冠状动脉血管塑造术 (PTCA) 是冠状动脉疾病的常见手术.
- 在PTCA后肌酸激酶 (CK) 升高的预后意义需要进一步澄清.
研究的目的:
- 调查选择性皮肤透光冠状动脉血管塑造术 (PTCA) 后肌酸激酶 (CK) 升高的预后价值.
主要方法:
- 追溯队列研究包括253名CK升高患者和120名对照患者.
- 随访持续时间超过3.5年.
- 评估的结果包括心脏死亡率和心肌梗塞.
主要成果:
- 在PTCA后CK升高的患者心脏病死亡率显著增加 (P=.02).
- 心脏病死亡率随着高峰CK水平的增加而增加 (P=.007).
- 多变量分析确定较高的峰值CK和较低的射出分数是心脏死亡率的关键预测因素.
结论:
- 在选择性PTCA后肌酸激酶的升高是晚期心脏死亡率增加的独立预测因子.
- 即使是轻微的CK升高也与晚期心脏病死亡风险显著增加有关.
- 这一发现无论临床因素,疾病严重程度或程序特征如何,都是如此.
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