Yang Bo, Wang Qi, Wang Rui, Xu Tao
Department of Urology, Peking University People's Hospital, Beijing, China.
Department of Urology, Peking University People's Hospital, Beijing, China,
Kidney Blood Press Res. 2018;43(6):1806-1812. doi: 10.1159/000495638. Epub 2018 Nov 30.
BACKGROUND/AIMS: Cardiovascular complications are the most common cause of death in individuals with autosomal dominant polycystic kidney disease (ADPKD), yet there is no substantial data concerning the clinical characteristics of acute myocardial infarction (AMI) in this population. This study thus aimed to investigate AMI in persons with ADPKD.
A retrospective analysis of ADPKD patients admitted to our hospital over a 13 year period was conducted. Age and gender-matched control patients without ADPKD were also selected at a ratio of 1: 10.
A total of 52 ADPKD and 520 non-ADPKD patients were enrolled in the present study, with those in the former group exhibiting significantly poorer kidney function. The distribution of AMI types differed significantly between these two groups. The incidence of ST-segment elevation myocardial infarction (STEMI) was higher (75.0%) and the incidence of non-ST segment elevation myocardial infarction (NSTEMI) was lower (25.0%) in the ADPKD group. At the onset of AMI, sudden cardiac death (SCD) was more common in ADPKD patients (11.5% vs. 4.6%). In terms of risk factors, the occurrence of hypertension was greater in ADPKD patients (78.8% vs. 39.6%). With regard to subsequent management, ADPKD patients had a higher prevalence of triple-branch coronary lesions (21.1% vs. 11.2%), undergoing more coronary artery bypass grafting (CABG) (7.7% vs. 5.4%) and fewer percutaneous coronary interventions (PCI) (73.1% vs. 84.6%). Overall, ADPKD patients had higher rates of mortality (13.5% vs. 6.2%).
ADPKD patients with AMI suffer from more severe conditions and difficult therapies, resulting in a poorer prognosis.
背景/目的：心血管并发症是常染色体显性多囊肾病（ADPKD）患者最常见的死亡原因，但关于该人群急性心肌梗死（AMI）的临床特征尚无大量数据。因此，本研究旨在调查ADPKD患者中的AMI情况。
对我院13年间收治的ADPKD患者进行回顾性分析。还按1:10的比例选取了年龄和性别匹配的无ADPKD的对照患者。
本研究共纳入52例ADPKD患者和520例非ADPKD患者，前一组患者的肾功能明显较差。这两组之间AMI类型的分布有显著差异。ADPKD组中ST段抬高型心肌梗死（STEMI）的发生率较高（75.0%），非ST段抬高型心肌梗死（NSTEMI）的发生率较低（25.0%）。在AMI发作时，ADPKD患者中心脏性猝死（SCD）更为常见（11.5%对4.6%）。在危险因素方面，ADPKD患者中高血压的发生率更高（78.8%对39.6%）。在后续治疗方面，ADPKD患者三支冠状动脉病变的患病率更高（21.1%对11.2%），接受冠状动脉旁路移植术（CABG）的比例更高（7.7%对5.4%），接受经皮冠状动脉介入治疗（PCI）的比例更低（73.1%对84.6%）。总体而言，ADPKD患者的死亡率更高（13.5%对6.2%）。
患有AMI的ADPKD患者病情更严重，治疗困难，预后较差。
