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动脉粥样硬化性心脏病患者冠状动脉扩张的患病率、预测因素及影响

Prevalence, Predictors, and Impact of Coronary Artery Ectasia in Patients With Atherosclerotic Heart Disease.

作者信息

Xi Ziwei, Qiu Hong, Guo Tingting, Wang Yong, Dou Kefei, Xu Bo, Wu Yongjian, Qiao Shubin, Yang Weixian, Yang Yuejin, Gao Runlin

机构信息

Department of Cardiology, Coronary Artery Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Thrombosis Center, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Angiology. 2023 Jan;74(1):47-54. doi: 10.1177/00033197221091644. Epub 2022 Apr 25.

Abstract

The clinical relevance of coronary artery ectasia (CAE) is poorly understood. We investigated the prevalence, potential predictors, and prognostic significance of CAE in patients with atherosclerotic coronary artery disease. Consecutive patients undergoing percutaneous coronary intervention (PCI) from January 2016 to December 2018 were included and followed up for 1 year. CAE was diagnosed as an abnormal dilation >1.5-fold the diameter of adjacent normal segments on angiography. A total of 590 patients with CAE were identified from 36 790 patients undergoing PCI (overall rate of CAE: 1.6%). In multivariate analysis, variables including body mass index >30 kg/m (risk ratio, RR: 2.413, = .018), ever-smoking (RR: 1.669, < .001), hypertension (RR: 1.221, = .025), acute myocardial infarction at admission (RR: 1.343, = .004), no diabetes (RR: .810, = .023), previous myocardial infarction (RR: 1.545, < .001), no left main disease (RR: .632, = .008) and multiple-vessel disease (RR: 1.326, = .001), increased C-reactive protein (RR: 1.006, = .012) were predictors of CAE. The incidence of adverse cardiovascular outcomes did not differ significantly between patients with or without CAE ( = .203). CAE is not uncommon among patients undergoing PCI in this cohort study. The presence of CAE vs its absence had no significant impact on 1-year clinical outcomes after PCI.

摘要

冠状动脉扩张(CAE)的临床相关性尚不清楚。我们调查了动脉粥样硬化性冠状动脉疾病患者中CAE的患病率、潜在预测因素及预后意义。纳入2016年1月至2018年12月期间连续接受经皮冠状动脉介入治疗(PCI)的患者,并随访1年。CAE在血管造影中被诊断为相邻正常节段直径异常扩张>1.5倍。在36790例接受PCI的患者中,共识别出590例CAE患者(CAE总发生率:1.6%)。多变量分析显示,包括体重指数>30kg/m(风险比,RR:2.413,P = .018)、曾经吸烟(RR:1.669,P < .001)、高血压(RR:1.221,P = .025)、入院时急性心肌梗死(RR:1.343,P = .004)、无糖尿病(RR:.810,P = .023)、既往心肌梗死(RR:1.545,P < .001)、无左主干病变(RR:.632,P = .008)和多支血管病变(RR:1.326,P = .001)、C反应蛋白升高(RR:1.006,P = .012)等变量是CAE的预测因素。有或无CAE患者不良心血管结局的发生率无显著差异(P = .203)。在这项队列研究中,CAE在接受PCI的患者中并不少见。CAE的存在与否对PCI术后1年的临床结局没有显著影响。

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