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冠状动脉造影术后脑血管病发病的前瞻性研究。

Prospective Study on the Incidence of Cerebrovascular Disease After Coronary Angiography.

机构信息

Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University.

Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University.

出版信息

J Atheroscler Thromb. 2018 Mar 1;25(3):224-232. doi: 10.5551/jat.41012. Epub 2017 Aug 30.

Abstract

AIM

Previous studies have reported a 10.2%-22% rate of silent cerebral infarction and a 0.1%-1% rate of symptomatic cerebral infarction after coronary angiography (CAG). However, the risk factors of cerebral infarction after CAG have not been fully elucidated. For this reason, we investigated the incidence and risk factors of CVD complications within 48 h after CAG using magnetic resonance imaging (MRI) (Diffusion-weighted MRI) at Kagoshima University Hospital.

METHODS

From September 2013 to April 2015, we examined the incidence and risk factors, including procedural data and patients characteristics, of cerebrovascular disease after CAG in consecutive 61 patients who underwent CAG and MRI in our hospital.

RESULTS

Silent cerebral infarction after CAG was observed in 6 cases (9.8%), and they should not show any neurological symptoms of cerebral infarction. Only prior coronary artery bypass grafting (CABG) was more frequently found in the stroke group (n=6) than that in the non-stroke group (n=55); however, no significant difference was observed (P=0.07). After adjusting for confounders, prior CABG was a significant independent risk factor for the incidence of stroke after CAG (odds ratio: 11.7, 95% confidence interval: 1.14-129.8, P=0.04).

CONCLUSIONS

We suggested that the incidence of cerebral infarction after CAG was not related to the catheterization procedure per se but may be caused by atherosclerosis with CABG.

摘要

目的

先前的研究报告称,冠状动脉造影(CAG)后会出现 10.2%-22%的无症状性脑梗死和 0.1%-1%的症状性脑梗死。然而,CAG 后脑梗死的危险因素尚未完全阐明。因此,我们使用磁共振成像(MRI)(弥散加权 MRI)在鹿儿岛大学医院调查了 CAG 后 48 小时内 CVD 并发症的发生率和危险因素。

方法

从 2013 年 9 月至 2015 年 4 月,我们检查了在我院接受 CAG 和 MRI 的连续 61 例患者中 CAG 后脑血管疾病的发生率和危险因素,包括手术数据和患者特征。

结果

CAG 后观察到 6 例(9.8%)出现无症状性脑梗死,且不应出现任何脑梗死的神经症状。仅先前的冠状动脉旁路移植术(CABG)在卒中组(n=6)中比非卒中组(n=55)更频繁出现;然而,差异无统计学意义(P=0.07)。在调整混杂因素后,先前的 CABG 是 CAG 后卒中发生的显著独立危险因素(比值比:11.7,95%置信区间:1.14-129.8,P=0.04)。

结论

我们认为 CAG 后脑梗死的发生率与导管插入术本身无关,而可能是由 CABG 引起的动脉粥样硬化所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f78/5868508/842b005f66fa/jat-25-224-g001.jpg

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