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在 SARS-CoV-2 爆发期间因 COVID-19 而接受冠状动脉造影术的患者的血管造影和临床特征:来自协作的、欧洲的、多中心登记处的结果。

Angiographic and Clinical Profile of Patients With COVID-19 Referred for Coronary Angiography During SARS-CoV-2 Outbreak: Results From a Collaborative, European, Multicenter Registry.

机构信息

Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.

Department of Cardiology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.

出版信息

Angiology. 2022 Feb;73(2):112-119. doi: 10.1177/00033197211028760. Epub 2021 Jul 28.

DOI:10.1177/00033197211028760
PMID:34318686
Abstract

Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.

摘要

关于因 2019 冠状病毒病 (COVID-19) 而接受冠状动脉造影 (CAG) 的患者的血管造影特征、临床特征和住院期间结局的数据很少。这是一项观察性研究,分析了来自 10 个欧洲中心的因 COVID-19 而接受 CAG 的确诊患者。我们纳入了 57 名患者(平均年龄:66±15 岁,82%为男性),其中 18%有既往心肌梗死 (MI),29%有肾功能不全和慢性肺部疾病。ST 段抬高型心肌梗死 (STEMI) 是 CAG 最常见的适应证 (58%)。在 CAG 后 86%的患者确诊为 COVID-19,其中 49%为轻症,21%完全无症状。79%的患者存在罪犯病变,42%的患者血栓负荷高;7%的患者发生支架血栓形成。在 40 天的随访中,16 名 (28%)患者发生了主要不良心血管事件 (MACE):12 例死亡(92%非心脏性),1 例 MI,2 例支架血栓形成,1 例卒中和 1 例 ST 段抬高型心肌梗死。在欧洲多中心注册研究中,在严重急性呼吸综合征冠状病毒 2 大流行的第一波期间因 COVID-19 感染而接受 CAG 的患者主要表现为 STEMI,且主要为合并症的男性。COVID-19 的严重程度通常不严重,21%的患者在 CAG 时无症状。经常发现有罪犯病变和高血栓负荷,支架血栓形成率为 7%。40 天时 MACE 的发生率较高(28%),主要是由于非心脏性死亡。

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