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不稳定型心绞痛患者血管重建的预测因素

Predictors of Revascularization in Patients with Unstable Angina.

作者信息

Budzianowski Jan, Faron Wojciech, Rzeźniczak Janusz, Słomczyński Marek, Hiczkiewicz Dariusz, Olejniczak Jacek, Hiczkiewicz Jarosław, Burchardt Paweł

机构信息

"Club 30", Polish Cardiac Society, 93-338 Łódź, Poland.

Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland.

出版信息

J Clin Med. 2024 Feb 15;13(4):1096. doi: 10.3390/jcm13041096.

Abstract

BACKGROUND

The factors that determine the necessity of coronary artery revascularization in patients with unstable angina (UA) have been supported by limited data. Therefore, this study aimed to identify the predictors of revascularization in patients with UA.

METHODS

The study included the recorded data of 3668 patients with UA who underwent cardiac catheterization (age 66 ± 9.2, men 70%); 2615 of them (71%) underwent revascularization (percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), or hybrid revascularization. The remaining 1053 patients (29%) had no significant coronary stenosis and were regarded as controls. Multivariable logistic regression analysis was performed to separate the predictors of revascularization.

RESULTS

It was found that severe angina (OR 2.7, 95%CI 1.9-3.7), male gender (OR 1.4, 95%CI 1.1-1.7), and hyperlipidemia were the predictors of revascularization. It was also noted that intraventricular conduction disorders including left and right bundle branch blocks and a history of previous revascularization and myocardial infarction were associated with lower odds of revascularization.

CONCLUSION

Overall, however, the predictive value of the studied factors proved to be poor and may still point to the multifactorial nature of significant coronary artery stenosis and the need for revascularization in patients with UA.

摘要

背景

关于不稳定型心绞痛(UA)患者冠状动脉血运重建必要性的决定因素,相关数据有限。因此,本研究旨在确定UA患者血运重建的预测因素。

方法

该研究纳入了3668例行心导管检查的UA患者的记录数据(年龄66±9.2岁,男性占70%);其中2615例(71%)接受了血运重建(经皮冠状动脉腔内血管成形术(PTCA)、冠状动脉旁路移植术(CABG)或杂交血运重建)。其余1053例患者(29%)无明显冠状动脉狭窄,被视为对照组。进行多变量逻辑回归分析以区分血运重建的预测因素。

结果

发现严重心绞痛(比值比2.7,95%置信区间1.9 - 3.7)、男性(比值比1.4,95%置信区间1.1 - 1.7)和高脂血症是血运重建的预测因素。还注意到包括左、右束支传导阻滞在内的室内传导障碍以及既往血运重建和心肌梗死病史与血运重建几率较低相关。

结论

然而,总体而言,所研究因素的预测价值较差,这可能仍表明严重冠状动脉狭窄具有多因素性质以及UA患者血运重建的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c990/10889168/65292d0d91d5/jcm-13-01096-g001.jpg

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