Chacón-Diaz Manuel
Instituto Nacional Cardiovascular INCOR, EsSalud, Lima, Perú. Instituto Nacional Cardiovascular INCOR, EsSalud Lima Perú.
Universidad Particular Cayetano Heredia, Lima, Perú. Universidad Peruana Cayetano Heredia Universidad Particular Cayetano Heredia Lima Peru.
Arch Peru Cardiol Cir Cardiovasc. 2023 Dec 27;4(4):151-156. doi: 10.47487/apcyccv.v4i4.329. eCollection 2023 Oct-Dec.
To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru.
Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals.
Eighteen cases and 18 controls were studied, most of them were men with an average age of 65 years. Thirty-six percent of the population came from high altitude; in this group 76.9% had coronary ectasia of the infarct-related artery. The mean hematocrit value was slightly higher in the high-altitude native (46 ± 7% versus 42 ± 5%, p=0.094). Multivariate conditional logistic regression did not find a significant relationship between exposure to high altitude and the risk of presenting CE (OR:6.03, IC95%: 0.30-118, p=0.236).
In patients with STEMI, we found no association between chronic exposure to high altitude and coronary ectasia.
在秘鲁一家高度专业化的心血管参考医院接受治疗的ST段抬高型心肌梗死（STEMI）患者中，评估长期暴露于高海拔与冠状动脉扩张（CE）之间的关联。
回顾性匹配病例对照研究。病例为患有CE的患者，对照为无CE的患者。考虑动脉高血压、糖尿病、血脂异常、吸烟和血细胞比容值等干预变量，评估CE与长期暴露于高海拔之间的关系。排除患有慢性炎症性疾病、慢性阻塞性肺疾病和既往血运重建的患者。应用多因素逻辑回归分析以获得比值比（OR）值及其各自的置信区间。
研究了18例病例和18例对照，大多数为男性，平均年龄65岁。36%的人群来自高海拔地区；在该组中，76.9%的患者梗死相关动脉存在冠状动脉扩张。高海拔地区原住民的平均血细胞比容值略高（46±7%对42±5%，p = 0.094）。多因素条件逻辑回归分析未发现高海拔暴露与发生CE的风险之间存在显著关联（OR：6.03，95%置信区间：0.30 - 118，p = 0.236）。
在STEMI患者中，我们未发现长期暴露于高海拔与冠状动脉扩张之间存在关联。
