Internal Medicine Wayne State University, Detroit, MI, USA; Internal Medicine, Baptist Health System, Montgomery, AL, USA.
Internal Medicine Wayne State University, Detroit, MI, USA.
Int J Cardiol. 2022 Jun 1;356:6-11. doi: 10.1016/j.ijcard.2022.04.005. Epub 2022 Apr 6.
The literature on prevalence and outcomes of coronary artery aneurysm (CAA) in the United States (US) is limited.
To study the prevalence, outcomes, and trends of CAA.
Data from the national readmissions database (NRD) sample that constitutes 49.1% of the stratified sample of all hospitals in the US were analyzed for CAA among coronary angiography (CA) related hospitalizations for the years 2012-2018.
A total of 6,843,910 index CA related hospitalizations were recorded for the years 2012-2018 in the NRD (Mean age 64.37 ± 13.30 years' 38.6% females). Of these 9671 (0.141%) were CAA, 5092 (52.7%) without-ACS and 4579 (47.3%) with ACS [NSTEMI occurred in 2907(63.5%) and STEMI in 1672(36.5%)]. In-hospital mortality among CAA was comparable to those without-CAA on angiography (n-209,2.17% vs n = 175,120,2.56%;p = 0.08). CAA patients who presented with ACS vs those without ACS had higher mortality (n = 150,3.28%vsn = 60,1.16%;p < 0.001) cardiogenic shock 6.9%vs2%, ventricular arrythmias 9.2%vs5.2%, coronary dissection 58%vs42.7%, and need for mechanical circulatory support 7%vs2.7% respectively. Percutaneous coronary intervention (PCI) was performed among 45.2% patients; however, on coarsened exact matching of baseline characteristics, PCI had no association with mortality, patients (OR 1.22, 95%CI0.69-2.16, p = 0.49). The prevalence of CAA on CA trend towards increased mortality with ACS increased over the years 2012-2018 (linear p-trend <0.05). The 30-day readmissions rate were 13.8% (non-CAA) vs 4.6% (CAA) p = 0.001 predominantly cardiovascular causes (50.9%vs70.7%) and PCI on readmission (7.06%vs17.5%).
CAA is an uncommon anomaly noted on coronary angiography. The higher mortality in patients with ACS and increasing trend of CAA-ACS warrants more research.
美国（US）关于冠状动脉瘤（CAA）的患病率和结局的文献有限。
研究 CAA 的患病率、结局和趋势。
对 2012 年至 2018 年全国再入院数据库（NRD）中与冠状动脉造影（CA）相关的住院患者中 CAA 的患病率、结局和趋势进行分析。NRD 样本占美国所有医院分层样本的 49.1%。
NRD 记录了 2012 年至 2018 年期间共 6843910 例与 CA 相关的指数住院治疗（平均年龄 64.37±13.30 岁，女性占 38.6%）。其中 9671 例（0.141%）为 CAA，5092 例（52.7%）无急性冠脉综合征（ACS），4579 例（47.3%）有 ACS [非 ST 段抬高型心肌梗死（NSTEMI）发生 2907 例（63.5%），ST 段抬高型心肌梗死（STEMI）发生 1672 例（36.5%）]。CAA 患者的院内死亡率与无 CAA 患者的死亡率相似（n=209，2.17%与 n=175120，2.56%；p=0.08）。与无 ACS 相比，ACS 患者的 CAA 患者死亡率更高（n=150，3.28%与 n=60，1.16%；p<0.001），心源性休克 6.9%与 2%，室性心律失常 9.2%与 5.2%，冠状动脉夹层 58%与 42.7%，机械循环支持 7%与 2.7%。45.2%的患者接受了经皮冠状动脉介入治疗（PCI）；然而，在对基线特征进行粗化精确匹配后，PCI 与死亡率无关，患者（OR 1.22，95%CI0.69-2.16，p=0.49）。CA 上 CAA 的患病率呈上升趋势，与 ACS 相关的死亡率呈上升趋势，2012 年至 2018 年期间呈线性趋势（p<0.05）。30 天再入院率为 13.8%（非 CAA）与 4.6%（CAA）（p=0.001），主要是心血管原因（50.9%与 70.7%）和再入院时的 PCI（7.06%与 17.5%）。
CAA 是冠状动脉造影上一种罕见的异常。ACS 患者死亡率较高且 CAA-ACS 的趋势增加，需要进一步研究。
