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估计脉搏波速度在预测急性心肌梗死患者心血管死亡率中的作用

Usefulness of Estimated Pulse Wave Velocity in Prediction of Cardiovascular Mortality in Patients With Acute Myocardial Infarction.

作者信息

Hsu Po-Chao, Lee Wen-Hsien, Tsai Wei-Chung, Chi Nai-Yu, Chang Ching-Tang, Chiu Cheng-An, Chu Chun-Yuan, Lin Tsung-Hsien, Lai Wen-Ter, Sheu Sheng-Hsiung, Su Ho-Ming

机构信息

Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.

出版信息

Am J Med Sci. 2021 Apr;361(4):479-484. doi: 10.1016/j.amjms.2020.10.023. Epub 2020 Oct 26.

Abstract

BACKGROUND

Pulse wave velocity (PWV) is an excellent index of arterial stiffness and can be used to predict long-term cardiovascular (CV) outcome. In recent years, estimated PWV (ePWV), calculated by equations using age and mean blood pressure, was also reported to be a significant predictor of CV outcomes. However, there was no literature discussing about usefulness of ePWV in patients of acute myocardial infarction (AMI) for prediction of long-term CV and overall mortality. Therefore, we conducted this study for further evaluation.

METHODS

A total of 187 patients with AMI admitted to cardiac care unit were enrolled. ePWV were calculated by the equations for each patient.

RESULTS

The median follow-up to mortality was 73 months (25th-75th percentile: 8-174 months). There were 35 and 125 patients documented as CV and overall mortality, respectively. Under univariable analysis, ePWV could independently predict long-term CV and overall mortality. However, after multivariable analysis, ePWV could only predict long-term CV mortality in AMI patients.

CONCLUSIONS

To the best of our knowledge, our study was the first to evaluate the usefulness of ePWV in AMI patients for prediction of long-term CV and overall mortality. Our study showed ePWV was not only easy to calculate by formula, but also an independent predictor for long-term CV mortality in univariable and multivariable analyses. Therefore, ePWV was a simple and useful tool to measure arterial stiffness and to predict CV mortality outcome in AMI patients without the necessity for equipment to measure PWV.

摘要

背景

脉搏波速度(PWV)是动脉僵硬度的一个优良指标,可用于预测长期心血管(CV)结局。近年来,通过使用年龄和平均血压的公式计算得出的估计PWV(ePWV),也被报道为CV结局的一个重要预测指标。然而,尚无文献讨论ePWV在急性心肌梗死(AMI)患者中预测长期CV和全因死亡率的效用。因此,我们开展了本研究以进行进一步评估。

方法

共纳入187例入住心脏监护病房的AMI患者。为每位患者通过公式计算ePWV。

结果

至死亡的中位随访时间为73个月(第25 - 75百分位数:8 - 174个月)。分别有35例和125例患者记录有CV死亡和全因死亡。在单变量分析中,ePWV可独立预测长期CV和全因死亡率。然而,经过多变量分析后,ePWV仅能预测AMI患者的长期CV死亡率。

结论

据我们所知,我们的研究是首个评估ePWV在AMI患者中预测长期CV和全因死亡率效用的研究。我们的研究表明,ePWV不仅易于通过公式计算,而且在单变量和多变量分析中均为长期CV死亡率的独立预测指标。因此,ePWV是一种简单且有用的工具,无需测量PWV的设备即可测量动脉僵硬度并预测AMI患者的CV死亡结局。

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