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年轻冠心病患者的临床特点及预后。

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease.

机构信息

Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland).

Department of Endocrinology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland).

出版信息

Med Sci Monit. 2020 Jul 1;26:e922957. doi: 10.12659/MSM.922957.

Abstract

BACKGROUND The objective of this study was to investigate the clinical characteristics and prognosis of coronary heart disease (CHD) in young patients. MATERIAL AND METHODS We included 972 CHD patients (≤50 years old) with coronary artery stenting who were prospectively enrolled and followed for 1 year. Clinical characteristics, risk factors, and predictors of outcomes were evaluated. RESULTS The prevalence of current smoker, hypertension, diabetes mellitus, dyslipidemia and positive family history of CHD were 18.9%, 34.3%, 14.5%, 4.4%, and 44.2%, respectively. Most of the patients underwent coronary stenting due to stable angina (48.8%) and unstable angina (UA; 48.1%). After 1-year follow-up, 64 patients (6.6%) experienced clinical outcomes and the most common event was UA (n=56). Compared to patients without clinical outcomes, those with outcomes were more likely to be male, have higher systolic blood pressure, more likely to have hypertension and diabetes mellitus, and more likely to be presented as unstable angina. Multivariate regression analysis showed only age (hazard ratio [HR]: 1.12 and 95% confidence interval [CI]: 1.07-1.26), smoking (HR: 1.15 and 95% CI: 1.06-1.23), presence of hypertension (HR: 1.19 and 95% CI: 1.13-1.31), and diabetes mellitus (HR: 1.16 and 95% CI: 1.09-1.28), more vessels with stenosis (HR: 1.27 and 95% CI: 1.20-1.48) and presented with acute coronary syndrome (HR: 1.35 and 95% CI: 1.21-1.55) were independently associated with clinical outcomes. CONCLUSIONS Most of the young (≤50 years of age) CHD patients had poor management of risk factors and better controlling these risk factors would be helpful for the primary and secondary prevention of premature CHD in Guangdong province.

摘要

背景

本研究旨在探讨年轻患者冠心病(CHD)的临床特征和预后。

材料与方法

我们前瞻性纳入了 972 例年龄≤50 岁接受冠状动脉支架置入术的 CHD 患者,随访 1 年。评估了临床特征、危险因素和结局预测因素。

结果

当前吸烟者、高血压、糖尿病、血脂异常和 CHD 阳性家族史的患病率分别为 18.9%、34.3%、14.5%、4.4%和 44.2%。大多数患者因稳定性心绞痛(48.8%)和不稳定型心绞痛(UA;48.1%)而行冠状动脉支架置入术。1 年随访期间,64 例(6.6%)患者发生临床结局,最常见的事件为 UA(n=56)。与无临床结局的患者相比,有临床结局的患者更可能为男性,收缩压更高,更可能患有高血压和糖尿病,且更可能表现为不稳定型心绞痛。多变量回归分析显示,仅年龄(风险比 [HR]:1.12,95%置信区间 [CI]:1.07-1.26)、吸烟(HR:1.15,95% CI:1.06-1.23)、高血压(HR:1.19,95% CI:1.13-1.31)、糖尿病(HR:1.16,95% CI:1.09-1.28)、狭窄血管更多(HR:1.27,95% CI:1.20-1.48)和急性冠状动脉综合征(HR:1.35,95% CI:1.21-1.55)与临床结局独立相关。

结论

大多数年轻(≤50 岁)CHD 患者的危险因素管理不佳,更好地控制这些危险因素有助于广东省早发 CHD 的一级和二级预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c917/7346752/5eacf81cfced/medscimonit-26-e922957-g001.jpg

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