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人类免疫缺陷病毒感染患者冠状动脉旁路移植术的结果

Outcomes of coronary artery bypass grafting in patients with human immunodeficiency virus infection.

作者信息

Wollner Gregor, Zimpfer Daniel, Manduric Marina, Laufer Günther, Rieger Armin, Sandner Sigrid E

机构信息

Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

出版信息

J Card Surg. 2020 Oct;35(10):2543-2549. doi: 10.1111/jocs.14828. Epub 2020 Jul 11.

Abstract

BACKGROUND

With early and effective antiretroviral therapy and improved survival for persons living with human immunodeficiency virus infection (PLHIV), this patient population now faces an increasingly elevated risk of cardiovascular disease. However, the data on outcomes after coronary artery bypass grafting (CABG) for revascularization of coronary artery disease (CAD) in HIV+ patients is limited.

METHODS

We conducted a retrospective analysis of 16 patients undergoing isolated CABG at the Medical University of Vienna from 2005 to 2018, who were HIV+ on admission. The primary endpoint of the study was survival. Secondary endpoints included the components of major adverse cardiac and cerebrovascular events (MACCE): cardiovascular death, stroke, myocardial infarction (MI), and repeat revascularization.

RESULTS

Patients were followed for a median of 49 months (range, 7-142 months). Survival was 100% and 90% at 1 and 3 years after CABG, respectively. There were no strokes. MI and subsequent repeat revascularization were observed in two patients.

CONCLUSION

CABG provides excellent short- and midterm survival and freedom from MACCE in HIV+ patients with CAD requiring revascularization.

摘要

背景

随着早期有效的抗逆转录病毒疗法以及人类免疫缺陷病毒感染(PLHIV)患者生存率的提高,这一患者群体现在面临着日益增加的心血管疾病风险。然而,关于HIV阳性患者因冠状动脉疾病(CAD)进行冠状动脉旁路移植术(CABG)以实现血管重建后的结局数据有限。

方法

我们对2005年至2018年在维也纳医科大学接受单纯CABG手术、入院时HIV呈阳性的16例患者进行了回顾性分析。该研究的主要终点是生存率。次要终点包括主要不良心脏和脑血管事件(MACCE)的组成部分:心血管死亡、中风、心肌梗死(MI)和再次血管重建。

结果

患者的中位随访时间为49个月(范围7 - 142个月)。CABG术后1年和3年的生存率分别为100%和90%。无中风发生。两名患者发生了心肌梗死和随后的再次血管重建。

结论

对于需要血管重建的CAD合并HIV阳性患者,CABG可提供出色的短期和中期生存率,且无MACCE发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b42/7586791/dfb545e27223/JOCS-35-2543-g001.jpg

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