Darabont Roxana Oana, Vișoiu Ionela Simona, Magda Ștefania Lucia, Stoicescu Claudiu, Vintilă Vlad Damian, Udroiu Cristian, Vinereanu Dragoș
Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu, 030167 Bucharest, Romania.
Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania.
Diagnostics (Basel). 2022 Apr 10;12(4):948. doi: 10.3390/diagnostics12040948.
Background: In this study, we aimed to describe the impact of MBs on atherosclerosis and survival, in patients with coronary artery disease (CAD). Methods: We retrospectively studied 1920 consecutive patients who underwent conventional coronary angiography for suspected CAD. Atherosclerotic load (AL), defined as the sum of degrees of stenosis, and general atherosclerotic load (GAL), representing the sum of AL, were compared between patients with MB and a control group without MB; patients in these groups were similar in age and sex. We assessed survival at 10 years after the last enrolled patient. Results: Prevalence of MB was 3.96%, predominantly in the mid-segment of left anterior descendent artery (LAD). In the presence of MB, GAL was lower (158.1 ± 93.7 vs. 205.3 ± 117.9, p = 0.004) with a lesser AL in the proximal (30.3 ± 39.9 vs. 42.9 ± 41.1, p = 0.038) and mid-segments (8.1 ± 20.0 vs. 25.3 ± 35.9, p < 0.001) of LAD. Based on a Multinominal Logistic Regression, we found that the presence of MB on LAD (regardless of its location on this artery) is a protective factor against atherosclerotic lesions, decreasing the probability of significant stenosis, especially of those ≥70%, on the entire artery (B −1.539, OR 4660; 95% CI = 1.873−11.595, p = 0.001) and on each of its segments as well: proximal LAD (B −1.275, OR 0.280; 95% CI = 0.015−5.073; p = 0.038), mid-LAD (B −1.879, OR 6.545; 95% CI = 1.492−28.712; p = 0.013) and distal LAD (B −0.900, OR 2.459, 95% CI = 2.459−2.459, p = 0.032). However, 10-year survival was similar between groups (76.70% vs. 74.30%, p = 0.740). Conclusion: The presence of MB on LAD proved to be a protective factor against atherosclerosis for the entire artery and for each of its segments, but it does not influence long-term survival in patients with CAD.
在本研究中，我们旨在描述心肌桥（MBs）对冠心病（CAD）患者动脉粥样硬化和生存的影响。方法：我们回顾性研究了1920例因疑似CAD接受传统冠状动脉造影的连续患者。比较了有MB的患者和无MB的对照组之间的动脉粥样硬化负荷（AL，定义为狭窄程度之和）以及代表AL总和的总体动脉粥样硬化负荷（GAL）；这些组中的患者在年龄和性别上相似。我们评估了最后一名入组患者10年后的生存率。结果：MB的患病率为3.96%，主要位于左前降支动脉（LAD）的中段。存在MB时，GAL较低（158.1±93.7 vs. 205.3±117.9，p = 0.004），LAD近端（30.3±39.9 vs. 42.9±41.1，p = 0.038）和中段（8.1±20.0 vs. 25.3±35.9，p < 0.001）的AL也较低。基于多项逻辑回归，我们发现LAD上存在MB（无论其在该动脉上的位置）是动脉粥样硬化病变的保护因素，可降低整个动脉（B -1.539，OR 4660；95%CI = 1.873 - 11.595，p = 0.001）及其各段出现显著狭窄（尤其是≥70%的狭窄）的概率：LAD近端（B -1.275，OR 0.280；95%CI = 0.015 - 5.073；p = 0.038）、LAD中段（B -1.879，OR 6.545；95%CI = 1.492 - 28.712；p = 0.013）和LAD远端（B -0.900，OR 2.459，95%CI = 2.459 - 2.459，p = 0.032）。然而，两组之间的10年生存率相似（76.70% vs. 74.30%，p = 0.740）。结论：LAD上存在MB被证明是整个动脉及其各段动脉粥样硬化的保护因素，但它不影响CAD患者的长期生存。
