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非阻塞性冠状动脉疾病患者需要严格控制所有心血管危险因素:来自波兰当地人群医疗记录的结果。

Patients with Non-Obstructive Coronary Artery Disease Require Strict Control of All Cardiovascular Risk Factors: Results from the Polish Local Population Medical Records.

作者信息

Hiczkiewicz Jarosław, Burchardt Paweł, Budzianowski Jan, Pieszko Konrad, Hiczkiewicz Dariusz, Musielak Bogdan, Winnicka-Zielińska Anna, Keller Daria M, Faron Wojciech, Rzeźniczak Janusz

机构信息

Department of Interventional Cardiology, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland.

Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland.

出版信息

J Clin Med. 2021 Jun 18;10(12):2704. doi: 10.3390/jcm10122704.

Abstract

The aim of the project was to compare patients treated with percutaneous transluminal coronary angioplasty (PTCA), who also had undergone PTCA in the past, with a group of people who had had no angiographic stenosis in the lumen of the coronary arteries in the past, and who also required PTCA during index hospitalization. The secondary aim was to compare the obtained data with the characteristics of a group of people who had undergone angiography twice and for whom no significant stenosis had been found in their coronary arteries. The study used registry data concerning 3085 people who had undergone at least two invasive procedures. Acute coronary syndrome (ACS) was significantly more often observed (Non-ST-segment elevation myocardial infarction (NSTEMI) OR 2.76 [1.91-3.99] and ST-segment elevation myocardial infarction (STEMI) OR 2.35 [1.85-2.99]) in patients with no significant coronary stenosis in the past (who required coronary angioplasty at the time of the study), compared to patients who had already had PTCA. They also demonstrated more frequent occurrence of 'multivessel disease'. This was probably most likely caused by inadequate control of cardiovascular risk factors, as determined by higher total cholesterol levels ([mg/dL] 193.7 ± 44.4 vs. 178.2 ± 43.7) and LDL (123.4 ± 36.2 vs. 117.7 ± 36.2). On the other hand, patients in whom no significant stenosis was found in two consecutive angiographies were more likely to be burdened with chronic obstructive pulmonary disease, atrial fibrillation and chronic kidney disease.

摘要

该项目的目的是将曾接受过经皮冠状动脉腔内血管成形术(PTCA)的患者,与过去冠状动脉管腔内无血管造影狭窄且在本次住院期间也需要进行PTCA的人群进行比较。次要目的是将获得的数据与一组接受过两次血管造影且冠状动脉未发现明显狭窄的人群的特征进行比较。该研究使用了涉及3085名至少接受过两次侵入性手术的人员的登记数据。与既往已接受过PTCA的患者相比,过去无明显冠状动脉狭窄(在研究时需要进行冠状动脉血管成形术)的患者中,急性冠状动脉综合征(ACS)的发生率显著更高(非ST段抬高型心肌梗死(NSTEMI)的比值比为2.76 [1.91 - 3.99],ST段抬高型心肌梗死(STEMI)的比值比为2.35 [1.85 - 2.99])。他们还表现出更频繁的“多支血管病变”。这很可能是由心血管危险因素控制不足导致的,这一点可通过更高的总胆固醇水平([mg/dL] 193.7 ± 44.4 vs. 178.2 ± 43.7)和低密度脂蛋白(123.4 ± 36.2 vs. 117.7 ± 36.2)来确定。另一方面,在连续两次血管造影中未发现明显狭窄的患者更易患慢性阻塞性肺疾病、心房颤动和慢性肾脏病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f16d/8233810/13389ff5abcd/jcm-10-02704-g001.jpg

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