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经皮冠状动脉介入治疗后急性冠状动脉综合征患者营养不良及高出血风险与长期预后的关系

Association of Malnutrition and High Bleeding Risk with Long-Term Prognosis in Patients with Acute Coronary Syndrome following Percutaneous Coronary Intervention.

作者信息

Kataoka Hiromitsu, Suzuki Sayumi, Suzuki Yuichi, Sato Ryota, Sano Makoto, Mogi Satoshi, Sakamoto Atsushi, Suwa Kenichiro, Naruse Yoshihisa, Ohtani Hayato, Saotome Masao, Shimizu Mikihiro, Odagiri Keiichi, Maekawa Yuichiro

机构信息

Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.

Center for Clinical Research, Hamamatsu University Hospital, Hamamatsu 431-3192, Japan.

出版信息

Medicines (Basel). 2023 Nov 30;10(12):62. doi: 10.3390/medicines10120062.

DOI:10.3390/medicines10120062
PMID:38132889
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10744455/
Abstract

BACKGROUND

Malnutrition in cardiovascular disease is associated with poor prognosis, especially in patients with heart failure and acute coronary syndrome (ACS). High bleeding risk is also linked to coronary artery disease prognosis, including ACS. However, whether the extent of malnutrition and high bleeding risk have a cumulative impact on the long-term prognosis of patients with ACS who undergo percutaneous coronary intervention remains unclear.

METHODS

We analyzed 275 patients with ACS treated with percutaneous coronary intervention. The Controlling Nutritional Status score and Japanese version of the Academic Research Consortium for High Bleeding Risk criteria (J-HBR) were retrospectively evaluated. The primary and secondary outcomes were adjusted using the inverse probability treatment weighting method.

RESULTS

The prevalence of moderate or severe malnutrition in this cohort was 16%. Kaplan-Meier analysis showed a significantly higher incidence of major adverse cardiovascular and cerebrovascular events in patients who were moderately or severely malnourished than in those who were not. Notably, the incidence of these major events was similar between severely malnourished patients with J-HBR and those without.

CONCLUSION

Moderate or severe malnutrition has a significant impact on the long-term prognosis of patients with ACS who undergo percutaneous coronary intervention.

摘要

背景

心血管疾病中的营养不良与预后不良相关,尤其是在心力衰竭和急性冠状动脉综合征(ACS)患者中。高出血风险也与冠状动脉疾病的预后相关,包括ACS。然而,营养不良的程度和高出血风险对接受经皮冠状动脉介入治疗的ACS患者的长期预后是否具有累积影响仍不清楚。

方法

我们分析了275例接受经皮冠状动脉介入治疗的ACS患者。回顾性评估控制营养状况评分和日本版高出血风险学术研究联盟标准(J-HBR)。主要和次要结局采用逆概率处理加权法进行调整。

结果

该队列中中度或重度营养不良的患病率为16%。Kaplan-Meier分析显示,中度或重度营养不良患者的主要不良心血管和脑血管事件发生率显著高于非营养不良患者。值得注意的是,伴有J-HBR的重度营养不良患者与不伴有J-HBR的患者之间这些主要事件的发生率相似。

结论

中度或重度营养不良对接受经皮冠状动脉介入治疗的ACS患者的长期预后有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/d191ec874a1f/medicines-10-00062-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/07e1b7a36893/medicines-10-00062-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/679bf4d63b8d/medicines-10-00062-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/fd51bf81702d/medicines-10-00062-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/d191ec874a1f/medicines-10-00062-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/07e1b7a36893/medicines-10-00062-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/679bf4d63b8d/medicines-10-00062-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/fd51bf81702d/medicines-10-00062-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/10744455/d191ec874a1f/medicines-10-00062-g004.jpg

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本文引用的文献

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The clinical value of the Controlling Nutritional Status score for predicting prognosis in systolic heart failure cases in the vulnerable phase.控制营养状况评分对预测收缩性心力衰竭脆弱期患者预后的临床价值。
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Application of food exchange portion method in home-based nutritional intervention for elderly patients with chronic heart failure.
食物交换份法在老年慢性心力衰竭患者家庭营养干预中的应用。
BMC Cardiovasc Disord. 2023 Feb 10;23(1):80. doi: 10.1186/s12872-023-03072-7.
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Nutritional Management of Sarcopenia and Frailty-Shift from Metabolic Syndrome to Frailty.肌肉减少症和衰弱的营养管理——从代谢综合征到衰弱的转变。
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