National Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Northern Theater Command, 83 Wenhua Road, Shenhe District, Shenyang, Liaoning, 110016, China.
The General Hospital of Northern Theater Command Training Base for Graduate, Dalian Medical University, Dalian, China.
BMC Cardiovasc Disord. 2024 Nov 4;24(1):617. doi: 10.1186/s12872-024-04300-4.
Multivessel disease(MVD) is linked to a poorer prognosis, increased complications, longer hospital stays, and higher in-hospital mortality when compared to single-vessel disease(SVD).The purpose of this study is to explore the clinically relevant predictors of acute cornary syndrome (ACS) combined with MVD.
This multicenter retrospective study included 68,378 ACS patients from 240 hospitals.The clinical data were retrospectively analyzed with univariate and multivariate analyses to identify the predictive factors for MVD.
When compared to SVD group, the MVD group showed a higher incidence of Major Adverse Cardiovascular Events(MACCEs), including all-cause death, myocardial infarction, stent thrombosis, and ischemic stroke during hospitalization, These differences were found to be statistically significant (P < 0.05) .The multivariate analysis revealed that age over 75 years (OR: 1.246, 95% CI: 1.176, 1.319), LDL/HDL ratio > 1.98 (OR: 1.245, 95% CI: 1.192, 1.302), history of heart failure (OR: 1.446, 95% CI: 1.143, 1.829), hypertension (OR: 1.274, 95% CI: 1.225, 1.325), diabetes (OR: 1.341, 95% CI: 1.278, 1.406), eGFRs < 60 ml/min·1.73m2 (OR: 1.179, 95% CI: 1.112, 1.249), family history of CAD (OR: 1.236, 95% CI: 1.108, 1.379), and high homocysteine levels (OR: 1.209, 95% CI: 1.029, 1.420) are independent predictors of MVD. The incidence of multivessel disease increased from 37.7 to 58.6% with an increase in the number of predictive factors, while the incidence of single vessel disease decreased from 62.3 to 41.4%. This trend was statistically significant (P trend < 0.001).
MVD is strongly correlated with a range of risk factors including diabetes, hypertension, LDL/HDL ratio greater than 1.98, hyperhomocysteinemia, family history of CAD, reduced glomerular filtration rate (< 60 ml/(min·1.73m), age over 75 years, and a history of heart failure. Furthermore, as the number of predictive factors increases, the odds ratio (OR) for patients with MVD also increases, reaching 2.344 times the OR for patients without any predictive factors.
与单支血管病变（SVD）相比，多支血管病变（MVD）与预后较差、并发症增加、住院时间延长和住院期间死亡率较高相关。本研究旨在探讨急性冠状动脉综合征（ACS）合并 MVD 的临床相关预测因素。
这项多中心回顾性研究纳入了来自 240 家医院的 68378 例 ACS 患者。使用单因素和多因素分析对临床数据进行回顾性分析，以确定 MVD 的预测因素。
与 SVD 组相比，MVD 组主要不良心血管事件（MACCEs）的发生率更高，包括住院期间全因死亡、心肌梗死、支架血栓形成和缺血性卒中，这些差异具有统计学意义（P<0.05）。多因素分析显示，年龄>75 岁（OR：1.246，95%CI：1.176，1.319）、LDL/HDL 比值>1.98（OR：1.245，95%CI：1.192，1.302）、心力衰竭史（OR：1.446，95%CI：1.143，1.829）、高血压（OR：1.274，95%CI：1.225，1.325）、糖尿病（OR：1.341，95%CI：1.278，1.406）、eGFR<60 ml/min·1.73m2（OR：1.179，95%CI：1.112，1.249）、CAD 家族史（OR：1.236，95%CI：1.108，1.379）和高同型半胱氨酸水平（OR：1.209，95%CI：1.029，1.420）是 MVD 的独立预测因素。随着预测因素数量的增加，多血管病变的发生率从 37.7%增加到 58.6%，而单血管病变的发生率从 62.3%下降到 41.4%。这种趋势具有统计学意义（P趋势<0.001）。
MVD 与多种危险因素密切相关，包括糖尿病、高血压、LDL/HDL 比值>1.98、高同型半胱氨酸血症、CAD 家族史、肾小球滤过率降低（<60 ml/（min·1.73m）、年龄>75 岁和心力衰竭史。此外，随着预测因素数量的增加，MVD 患者的优势比（OR）也增加，达到无任何预测因素患者的 2.344 倍。
