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年轻女性经皮冠状动脉介入治疗后的临床特征、未来心脏事件和预后因素。

Clinical features, future cardiac events, and prognostic factors following percutaneous coronary intervention in young female patients.

机构信息

Department of Cardiology, Toyota Kosei Hospital, Toyota, Japan.

Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan.

出版信息

Heart Vessels. 2024 Jun;39(6):505-513. doi: 10.1007/s00380-024-02369-7. Epub 2024 Feb 27.

DOI:10.1007/s00380-024-02369-7
PMID:38411632
Abstract

BACKGROUND

The proportion of young females among the patients who undergo percutaneous coronary intervention (PCI) is relatively small, and information on their clinical characteristics is limited. This study investigated the clinical characteristics and prognostic factors for future cardiac events in young females who underwent PCI.

METHODS

This multicenter observational study included 187 consecutive female patients aged < 60 years who underwent PCI in seven hospitals. The primary composite endpoint was the incidence of cardiac death, nonfatal myocardial infarction, and target vessel revascularization.

RESULTS

The mean patient age was 52.1 ± 6.1 years and 89 (47.6%) had diabetes, and renal dysfunction (an estimated glomerular filtration rate < 60 mL/min/1.73 m) was observed in 38 (20.3%). During a median follow-up of 3.3 years, the primary endpoint occurred in 28 patients. The Cox proportional hazards models showed that renal dysfunction was an independent predictor for the primary endpoint (hazard ratio 3.04, 95% confidence interval 1.25-7.40, p = 0.01), as well as multivessel disease (hazard ratio 2.79, 95% confidence interval 1.12-6.93, p = 0.03). Patients with renal dysfunction had a significantly higher risk for the primary endpoint than those without renal dysfunction.

CONCLUSIONS

Renal dysfunction was strongly associated with future cardiac events in young females who underwent PCI.

摘要

背景

在接受经皮冠状动脉介入治疗(PCI)的患者中,年轻女性的比例相对较小,关于她们临床特征的信息有限。本研究旨在探讨年轻女性 PCI 后的临床特征和未来心脏事件的预后因素。

方法

本多中心观察性研究纳入了 7 家医院的 187 名年龄<60 岁的连续女性 PCI 患者。主要复合终点为心脏死亡、非致死性心肌梗死和靶血管血运重建的发生率。

结果

患者的平均年龄为 52.1±6.1 岁,89 名(47.6%)患有糖尿病,38 名(20.3%)存在肾功能不全(估算肾小球滤过率<60ml/min/1.73m)。中位随访 3.3 年后,28 名患者发生了主要终点事件。Cox 比例风险模型显示,肾功能不全是主要终点的独立预测因素(风险比 3.04,95%置信区间 1.25-7.40,p=0.01),多支血管病变也是主要终点的独立预测因素(风险比 2.79,95%置信区间 1.12-6.93,p=0.03)。肾功能不全患者的主要终点风险明显高于无肾功能不全患者。

结论

肾功能不全与年轻女性 PCI 后的未来心脏事件密切相关。

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