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血液透析时长对行经皮冠状动脉介入治疗的血液透析患者冠状动脉钙化的影响。

Impact of Hemodialysis Duration on Coronary Artery Calcification Among Hemodialysis Patients Who Underwent Percutaneous Coronary Intervention.

机构信息

Department of Cardiology, 73622Yokosuka Kyosai Hospital, Yokosuka, Japan.

13100Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Angiology. 2022 Sep;73(8):764-771. doi: 10.1177/00033197211073407. Epub 2022 Mar 22.

Abstract

Our study aimed to evaluate the prevalence and impact of coronary artery calcification (CAC) on hemodialysis (HD) patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We enrolled 211 HD patients who underwent PCI (men: n = 155, age: 71 ± 1 0 years). Severe CAC was defined as calcification with an arc of 360° on intravascular ultrasound. Multivariate analysis was performed to determine the predictors of severe CAC. The impact of severe CAC on target lesion revascularization (TLR) was evaluated. Patients with severe CAC (46%) had a higher incidence of diabetes mellitus (DM) (79 vs 59%, = .003) and longer HD duration (7.7 vs 3.4 years, .001) than those with non-severe CAC. Multivariate analysis demonstrated that DM, HD duration, and angiographic calcification were significant predictors for severe CAC (odds ratio 4.42, 1.13, and 6.62; .001, .001, and .001, respectively). After the median follow-up period of 580 days (interquartile range, 302-730 days), Kaplan-Meier curve analysis revealed that severe CAC was associated with an increased risk for TLR (χ 12.7; = .002). In HD patients with CAD after PCI, DM and HD duration were significant predictors for severe CAC. Furthermore, severe CAC was associated with an increased risk for TLR.

摘要

我们的研究旨在评估经皮冠状动脉介入治疗(PCI)的冠心病(CAD)血液透析(HD)患者冠状动脉钙化(CAC)的流行情况及其影响。我们纳入了 211 名接受 PCI 的 HD 患者(男性:n = 155,年龄:71 ± 1 0 岁)。严重 CAC 定义为血管内超声显示的 360°钙化弧。进行多变量分析以确定严重 CAC 的预测因素。评估严重 CAC 对靶病变血运重建(TLR)的影响。严重 CAC 患者(46%)的糖尿病(DM)发生率(79%比 59%,.003)和 HD 持续时间(7.7 年比 3.4 年, .001)均高于非严重 CAC 患者。多变量分析表明,DM、HD 持续时间和血管造影钙化是严重 CAC 的显著预测因素(优势比 4.42、1.13 和 6.62;.001、.001 和.001)。在中位随访 580 天(四分位距,302-730 天)后,Kaplan-Meier 曲线分析显示严重 CAC 与 TLR 风险增加相关(χ 12.7;.002)。在 PCI 后 CAD 的 HD 患者中,DM 和 HD 持续时间是严重 CAC 的显著预测因素。此外,严重 CAC 与 TLR 风险增加相关。

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