Yokokawa Tetsuro, Yoshihisa Akiomi, Kiko Takatoyo, Shimizu Takeshi, Misaka Tomofumi, Yamaki Takayoshi, Kunii Hiroyuki, Nakazato Kazuhiko, Ishida Takafumi, Takeishi Yasuchika
Department of Cardiovascular Medicine, Fukushima Medical University Fukushima Japan.
Department of Pulmonary Hypertension, Fukushima Medical University Fukushima Japan.
Circ Rep. 2020 Jan 28;2(2):89-94. doi: 10.1253/circrep.CR-19-0121.
Coronary revascularization is important in heart failure (HF) with ischemic etiology. Coronary scoring systems are useful to evaluate coronary artery disease, but said systems for residual stenosis after revascularization are still poorly understood. Therefore, the aim of the current study was to clarify the prognostic impact of residual stenosis using a coronary scoring system, Gensini score, in HF patients after percutaneous coronary intervention (PCI). We analyzed consecutive hospitalized ischemic HF patients (n=199) who underwent PCI. We calculated residual Gensini score after PCI, and divided the patients into 2 groups based on median residual Gensini score. The patients with high scores (≥10, n=101) had a higher prevalence of anemia, lower prevalence of dyslipidemia, and lower left ventricular ejection fraction, compared with those with low scores (<10, n=98). During the median follow-up period of 1,581 days (range, 20-2,896 days), the high-score patients had a higher cardiac mortality than the low-score group (log rank, P=0.001). In patients with HF after PCI, residual Gensini score was associated with long-term cardiac mortality. Residual Gensini score may be a useful index for risk stratification of HF after PCI.
冠状动脉血运重建对于缺血性病因的心力衰竭（HF）患者很重要。冠状动脉评分系统有助于评估冠状动脉疾病，但对于血运重建后残余狭窄的此类系统仍了解不足。因此，本研究的目的是使用冠状动脉评分系统——Gensini评分，阐明经皮冠状动脉介入治疗（PCI）后HF患者残余狭窄的预后影响。我们分析了连续住院的接受PCI的缺血性HF患者（n = 199）。我们计算了PCI后的残余Gensini评分，并根据残余Gensini评分中位数将患者分为两组。与低分患者（<10，n = 98）相比，高分患者（≥10，n = 101）贫血患病率更高，血脂异常患病率更低，左心室射血分数更低。在1581天（范围20 - 2896天）的中位随访期内，高分患者的心脏死亡率高于低分患者（对数秩检验，P = 0.001）。在PCI后的HF患者中，残余Gensini评分与长期心脏死亡率相关。残余Gensini评分可能是PCI后HF风险分层的有用指标。
