Boutaybi Mohammed, Aloutmani Badia, El-Azrak Mohammed, Ismaili Nabila, El Ouafi Noha
Department of Cardiology, Mohammed VI University Hospital.
Epidemiological Laboratory of Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco.
Ann Med Surg (Lond). 2023 Jun 8;85(8):3791-3796. doi: 10.1097/MS9.0000000000000941. eCollection 2023 Aug.
Cardiovascular diseases, particularly acute coronary syndrome, are the leading cause of death in chronic hemodialysis patients. Our study aims to analyze the pathophysiological, clinical, angiographic, and therapeutic characteristics of coronary heart disease in hemodialysis patients.
This single-centered retrospective descriptive study included 34 hemodialysis patients hospitalized in the cardiovascular ICU.
The mean age of patients in our study was 64.4±11.3 years. The main cardiovascular risk factor found in our study was age, with a prevalence of 76.50%, followed by hypertension, with a prevalence of 67.60%. Diabetes was present in 55.90% of patients. The authors also found that 17.90% of patients were obese, and 29.40% had abdominal obesity. The main cause of renal disease in our study was diabetic nephropathy (52.90% of cases), followed by hypertensive nephropathy (23.50% of cases). ST segment elevation myocardial infarction was found in 14.70% of cases, and non-ST-segment elevation myocardial infarction in 85.30% of cases. Coronary angiography was performed in 76.40% of patients. Single-vessel coronary artery disease (CAD) was found in 20%, two-vessel CAD in 50%, and three-vessel CAD in 30% of the cases. Coronary artery calcifications were observed in 21.42% of cases. 38.23% had an angioplasty, and 20.58% were referred for a coronary artery bypass graft.
Despite the high mortality rate after acute coronary syndrome, hemodialysis patients are less likely to undergo diagnostic angiography or coronary revascularization. Patients on hemodialysis tend to have multiple, diffuse, calcified CAD.
心血管疾病，尤其是急性冠状动脉综合征，是慢性血液透析患者的主要死因。我们的研究旨在分析血液透析患者冠心病的病理生理、临床、血管造影和治疗特征。
这项单中心回顾性描述性研究纳入了34名入住心血管重症监护病房的血液透析患者。
我们研究中患者的平均年龄为64.4±11.3岁。我们研究中发现的主要心血管危险因素是年龄，患病率为76.50%，其次是高血压，患病率为67.60%。55.90%的患者患有糖尿病。作者还发现17.90%的患者肥胖，29.40%的患者有腹型肥胖。我们研究中肾病的主要原因是糖尿病肾病（52.90%的病例），其次是高血压肾病（23.50%的病例）。14.70%的病例发现ST段抬高型心肌梗死，85.30%的病例发现非ST段抬高型心肌梗死。76.40%的患者进行了冠状动脉造影。20%的病例发现单支冠状动脉疾病（CAD），50%的病例发现两支冠状动脉疾病，30%的病例发现三支冠状动脉疾病。21.42%的病例观察到冠状动脉钙化。38.23%的患者进行了血管成形术，20.58%的患者接受了冠状动脉搭桥术。
尽管急性冠状动脉综合征后死亡率很高，但血液透析患者接受诊断性血管造影或冠状动脉血运重建的可能性较小。接受血液透析的患者往往患有多发、弥漫、钙化的CAD。
