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尽管腹主动脉瘤体积较小,但急性冠状动脉综合征患者1年时的心血管预后与腹主动脉瘤相关。

Cardiovascular prognosis at 1-year of patients with acute coronary syndrome is related to abdominal aortic aneurysm despite small size of the aneurysm.

作者信息

Bui Huu Tri, Barbe Coralie, Nazeyrollas Pierre, Metz Damien, Long Anne

机构信息

Department of Vascular Medecine, Centre Hospitalier Universitaire de Reims, Reims, France.

出版信息

Ann Vasc Surg. 2011 Oct;25(7):913-9. doi: 10.1016/j.avsg.2011.03.005. Epub 2011 May 28.

DOI:10.1016/j.avsg.2011.03.005
PMID:21620652
Abstract

BACKGROUND

Global cardiovascular (CV) risk associated with abdominal aortic aneurysms (AAAs) has been poorly documented. The aim of this study was to evaluate whether the presence of AAA in patients hospitalized for acute coronary syndrome with coronary stenosis (≥50%) was associated with an increased CV risk at 1-year follow-up.

METHODS

Between February 1, 2008 and March 30, 2009, 304 patients admitted for acute coronary syndrome with significant (≥50% stenosis) coronary lesions underwent echocardiography to check for presence of AAA. Twenty AAAs were diagnosed, of average (±standard deviation) diameter 33 ± 3.7 mm. Follow-up at 1 year was available for 288 patients (95%). Variables recorded at 1 year were death, cause of death, and occurrence of nonfatal CV events of cardiac or peripheral vascular origin.

RESULTS

During follow-up, 65 patients (22.6%) experienced an event (all-cause death or nonfatal CV event), including 21 deaths (7.3%) and 44 nonfatal CV events (15.3%). The presence of AAA significantly increased the risk of any CV event (fatal or nonfatal) at 1 year (hazard ratio: 2.96, 95% CI: 1.49-5.89, p = 0.002) but did not influence overall mortality or CV mortality.

CONCLUSION

Our results show that in patients with coronary artery disease already at high CV risk, the presence of AAA was associated with worse CV prognosis at 1 year, and incurred an increased risk of occurrence of any CV event (fatal and nonfatal).

摘要

背景

与腹主动脉瘤(AAA)相关的全球心血管(CV)风险记录不足。本研究的目的是评估因冠状动脉狭窄(≥50%)而住院治疗急性冠状动脉综合征的患者中AAA的存在是否与1年随访时CV风险增加相关。

方法

在2008年2月1日至2009年3月30日期间,304例因急性冠状动脉综合征且有显著(≥50%狭窄)冠状动脉病变而入院的患者接受了超声心动图检查以检查AAA的存在情况。诊断出20例AAA,平均(±标准差)直径为33±3.7毫米。288例患者(95%)有1年的随访数据。1年时记录的变量包括死亡、死亡原因以及心脏或外周血管源性非致命CV事件的发生情况。

结果

在随访期间,65例患者(22.6%)发生了事件(全因死亡或非致命CV事件),包括21例死亡(7.3%)和44例非致命CV事件(15.3%)。AAA的存在显著增加了1年时任何CV事件(致命或非致命)的风险(风险比:2.96,95%置信区间:1.49 - 5.89,p = 0.002),但不影响总体死亡率或CV死亡率。

结论

我们的结果表明,在已经具有高CV风险的冠状动脉疾病患者中,AAA的存在与1年时更差的CV预后相关,并且会增加任何CV事件(致命和非致命)发生的风险。

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