Sheng Qianqian, Zhao Huiqiang, Wu Shanshan, Liu Ruifeng
Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
Medicine (Baltimore). 2020 Sep 4;99(36):e21983. doi: 10.1097/MD.0000000000021983.
Coronary artery ectasia (CAE) patients were more prone to present with acute myocardial infarction (AMI), this case-control research aimed to explore the underlying factors relating AMI for them.This study investigated a serial of 119 patients who underwent coronary angiography and were diagnosed as CAE between the years 2016 and 2017 at the Beijing Friendship Hospital; 32 of the patients developed AMI and 87 did not develop AMI. The possible factors relating to AMI, including disease history, cardiovascular risk factors, thrombotic condition, inflammation status, and coronary imaging characteristics, were comprehensively compared between CAE patients with and without AMI.CAE patients with AMI had a lower antiplatelet rate, a higher blood low-density lipoprotein cholesterol level, increased neutrophil to lymphocyte (NL) ratio, higher Gensini score, and larger proportions of Markis type II. Logistic regression analysis also indicated that AMI history, lower antiplatelet rate, higher NL ratio, higher low-density lipoprotein cholesterol level and Gensini score, as well as Markis type II were associated with AMI in CAE patients.AMI history, lower antiplatelet treatment rates, poor blood lipid control and higher coronary stenosis extent, higher inflammatory response, and Markis type II were closely related to the incidence of AMI in CAE patients.
冠状动脉扩张(CAE)患者更容易发生急性心肌梗死(AMI),本病例对照研究旨在探讨其发生AMI的潜在因素。本研究调查了2016年至2017年间在北京友谊医院接受冠状动脉造影并被诊断为CAE的119例患者;其中32例患者发生了AMI,87例未发生AMI。对发生AMI和未发生AMI的CAE患者,全面比较了与AMI相关的可能因素,包括病史、心血管危险因素、血栓形成情况、炎症状态和冠状动脉影像学特征。发生AMI的CAE患者抗血小板率较低、血液低密度脂蛋白胆固醇水平较高、中性粒细胞与淋巴细胞(NL)比值升高、Gensini评分较高,且Markis II型比例较大。Logistic回归分析还表明,AMI病史、较低的抗血小板率、较高的NL比值、较高的低密度脂蛋白胆固醇水平和Gensini评分以及Markis II型与CAE患者发生AMI有关。AMI病史、较低的抗血小板治疗率、血脂控制不佳、较高的冠状动脉狭窄程度、较高的炎症反应以及Markis II型与CAE患者AMI的发生率密切相关。