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经皮冠状动脉介入治疗后的海拔高度与预后:一项倾向评分匹配分析。

Altitude and prognosis after PCI: A propensity score-matched analysis.

作者信息

Yan Si-Yu, Ma Li-Hong, Yang Wei-Xian

机构信息

Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Heliyon. 2024 Jun 25;10(13):e33577. doi: 10.1016/j.heliyon.2024.e33577. eCollection 2024 Jul 15.

Abstract

BACKGROUND

The impact of altitude on the prognosis of patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) deserves further discussion and research.

METHODS

We conducted a post hoc analysis of a prospective observational study involving 5453 patients post-PCI, divided into medium-altitude and low-altitude groups. To control for confounding factors, propensity score matching was employed to pair patients with similar baseline characteristics between the two groups. The impact of altitude factors on patients' prognosis post-PCI was examined through endpoint events over a 2-year follow-up period.

RESULTS

During the 2-year follow-up, patients at medium altitude exhibited a lower risk of MACE (including cardiovascular mortality, myocardial infarction, revascularization, and stroke) compared to those at low altitude (1196 versus 1196 patients [medium-altitude versus low-altitude, respectively]; hazard ratio [HR], 0.781 [95 % CI, 0.629-0.969]; P = 0.025) during 2-year follow-up. Even after excluding stroke, a significant difference in heart-related adverse events (HRAE) persisted between the two groups (HR, 0.794; 95 % CI, 0.636-0.991; P = 0.042). The incidences of individual MACE components were not significantly different between the two groups.

CONCLUSIONS

Patients post-PCI residing at medium altitude exhibited a lower risk of 2-year MACE compared to those at low altitude. Further research is necessary to provide more robust evidence.

摘要

背景

海拔高度对经皮冠状动脉介入治疗(PCI)后冠心病(CAD)患者预后的影响值得进一步探讨和研究。

方法

我们对一项前瞻性观察性研究进行了事后分析,该研究纳入了5453例PCI术后患者,分为中海拔组和低海拔组。为控制混杂因素,采用倾向得分匹配法对两组间具有相似基线特征的患者进行配对。通过2年随访期内的终点事件,研究海拔因素对PCI术后患者预后的影响。

结果

在2年随访期间,中海拔地区的患者发生主要不良心血管事件(MACE,包括心血管死亡、心肌梗死、血运重建和中风)的风险低于低海拔地区的患者(分别为1196例对1196例[中海拔对低海拔];风险比[HR],0.781[95%CI,0.629 - 0.969];P = 0.025)。即使排除中风后,两组间心脏相关不良事件(HRAE)仍存在显著差异(HR,0.794;95%CI,0.636 - 0.991;P = 0.042)。两组间各MACE组分的发生率无显著差异。

结论

与低海拔地区的患者相比,居住在中海拔地区的PCI术后患者发生2年MACE的风险较低。需要进一步研究以提供更有力的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43a0/11292508/bb196fe7f135/gr1.jpg

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