冠状动脉疾病治疗模式和决定因素：沙特阿拉伯的横断面研究。
Patterns and determinants of treatment for coronary artery disease: A cross-sectional study in the Kingdom of Saudi Arabia.
机构信息
From the Department of Family and Community Medicine (Al-Ghamdi, AlAjmi); from the College of Medicine (Aldosari), Prince Sattam Bin Abdulaziz University, Al Kharj; and from the Adult Critical Care Medicine Department (Aldosari), Security Forces Hospital Program, Riyadh, Kingdom of Saudi Arabia.
出版信息
Saudi Med J. 2021 Aug;42(8):895-902. doi: 10.15537/smj.2021.42.8.20210219.
OBJECTIVES
To determine the clinical and coronary angiographic characteristics of patients with coronary artery disease (CAD) and the patterns and determinants of CAD treatment in Kingdom of Saudi Arabia (KSA).
METHODS
We conducted a cross-sectional study including 242 patients at 3 hospitals in KSA between June 2018 and June 2019. We included all patients aged ≥18 years diagnosed with CAD on angiography. We carried out a multinomial logistic regression to ascertain the determinants of treatment patterns and treatment modalities. Covariates for this multivariate analysis were selected based on univariate regressions.
RESULTS
The study population had a mean ± standard deviation of 58.3 ± 11.8 years, and 66.1% were male. The most frequent cardiovascular risk factor was diabetes (58.7%). Lesions involving the left anterior descending were reported among 68.6%, left circumflex among 51.2%, and right coronary arteries (RCA) among 48.8% of our patients. The most common treatment was the best medical therapy (lifestyle modifications and medical management), prescribed to 69.8% of patients. Patients aged ≤60 years with the left main disease or disease of the ramus had a higher likelihood of undergoing coronary artery bypass grafting (CABG). Contrarily, patients with RCA lesions were more likely to undergo a percutaneous coronary intervention (PCI).
CONCLUSION
Patient age and anatomical localization of coronary atherosclerotic lesions were the main determinants of treatment with CABG or PCI.
目的
确定沙特阿拉伯王国（KSA）冠心病（CAD）患者的临床和冠状动脉造影特征，以及 CAD 治疗的模式和决定因素。
方法
我们进行了一项横断面研究，纳入了 2018 年 6 月至 2019 年 6 月在 KSA 的 3 家医院的 242 例患者。我们纳入了所有经血管造影诊断为 CAD 的年龄≥18 岁的患者。我们进行了多项逻辑回归分析，以确定治疗模式和治疗方式的决定因素。该多变量分析的协变量是根据单变量回归选择的。
结果
研究人群的平均年龄±标准差为 58.3±11.8 岁，66.1%为男性。最常见的心血管危险因素是糖尿病（58.7%）。我们的患者中，68.6%报告存在左前降支病变，51.2%存在左回旋支病变，48.8%存在右冠状动脉（RCA）病变。最常见的治疗方法是最佳药物治疗（生活方式改变和药物管理），69.8%的患者接受了这种治疗。年龄≤60 岁、左主干病变或分支病变的患者更有可能接受冠状动脉旁路移植术（CABG）。相反，RCA 病变患者更有可能接受经皮冠状动脉介入治疗（PCI）。
结论
患者年龄和冠状动脉粥样硬化病变的解剖定位是决定 CABG 或 PCI 治疗的主要因素。
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