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药物洗脱支架植入患者中估计脉搏波速度对临床结局的预测作用

Estimated Pulse Wave Velocity in the Prediction of Clinical Outcomes in Patients Undergoing Drug-Eluting Stent Implantation.

作者信息

Kim Hack-Lyoung, Joh Hyun Sung, Lim Woo-Hyun, Seo Jae-Bin, Kim Sang-Hyun, Zo Joo-Hee, Kim Myung-A

机构信息

Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea.

出版信息

J Clin Med. 2023 Sep 8;12(18):5855. doi: 10.3390/jcm12185855.

DOI:10.3390/jcm12185855
PMID:37762796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10531714/
Abstract

Background The prognostic value of estimated pulse wave velocity (ePWV) has been infrequently explored in high-risk patient groups. Our study aimed to evaluate the prognostic significance of ePWV among patients undergoing a percutaneous coronary intervention (PCI) with a drug-eluting stent (DES). Methods A total of 4119 consecutive subjects who underwent a PCI with a DES (mean age, 67.1 ± 11.6 years and 33.1% were female) were retrospectively analyzed. ePWV was calculated based on the patient's age and mean blood pressure. Major adverse cardiovascular events (MACE), including cardiac death, non-fatal myocardial infarction, coronary revascularization, and ischemic stroke, were evaluated. Results During a median follow-up duration of 3.51 years (interquartile range, 1.35-6.37 years), there were 746 MACEs (18.1%). A multivariable analysis showed that a higher ePWV was associated with a higher MACE incidence (middle tertile vs. the lowest tertile: hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.81-3.42; < 0.001; the highest tertile vs. the lowest tertile: HR, 6.18; 95% CI, 4.33-8.80; < 0.001) The inclusion of ePWV data significantly increased the global chi-square values when added to the clinical information (from 96 to 128; < 0.001). Conclusion ePWV demonstrated a significant association with MACEs in patients who underwent DES implantation. Given its relative simplicity to calculate, ePWV could potentially serve as a valuable instrument for stratifying cardiovascular risks within this high-risk patient population.

摘要

背景

估计脉搏波速度(ePWV)在高危患者群体中的预后价值鲜有研究。我们的研究旨在评估接受药物洗脱支架(DES)经皮冠状动脉介入治疗(PCI)患者中ePWV的预后意义。方法:回顾性分析4119例连续接受DES PCI的患者(平均年龄67.1±11.6岁,女性占33.1%)。根据患者年龄和平均血压计算ePWV。评估主要不良心血管事件(MACE),包括心源性死亡、非致死性心肌梗死、冠状动脉血运重建和缺血性卒中。结果:在中位随访期3.51年(四分位间距1.35 - 6.37年)内,发生746例MACE(18.1%)。多变量分析显示,较高的ePWV与较高的MACE发生率相关(中间三分位数与最低三分位数相比:风险比[HR],2.49;95%置信区间[CI],1.81 - 3.42;<0.001;最高三分位数与最低三分位数相比:HR,6.18;95%CI,4.33 - 8.80;<0.001)。将ePWV数据添加到临床信息中时,显著增加了整体卡方值(从96增至128;<0.001)。结论:在接受DES植入的患者中,ePWV与MACE显著相关。鉴于其计算相对简单,ePWV可能成为该高危患者群体心血管风险分层的有价值工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/bcccd3ea97a6/jcm-12-05855-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/426883d583ad/jcm-12-05855-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/518fdbef2186/jcm-12-05855-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/5f8cdeb01c64/jcm-12-05855-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/028a9a64fafd/jcm-12-05855-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/bcccd3ea97a6/jcm-12-05855-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/426883d583ad/jcm-12-05855-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/518fdbef2186/jcm-12-05855-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/5f8cdeb01c64/jcm-12-05855-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/028a9a64fafd/jcm-12-05855-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e2/10531714/bcccd3ea97a6/jcm-12-05855-g005.jpg

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