Inzunza-Cervantes Gustavo, Herrera-Gavilanes Juan Ramón, Félix-Córdova Josué Abisai, Padilla-Islas Luis Alejandro, Ornelas-Aguirre José Manuel, Cortés-García Víctor Adrián
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, México.
Universidad de Sonora, Departamento de Ciencias de la Salud. Ciudad Obregón, Sonora, México.
Rev Med Inst Mex Seguro Soc. 2024 Jul 1;62(4):1-9. doi: 10.5281/zenodo.11397136.
Severe diffuse coronary artery disease with anatomy that is not amenable to revascularization represents a poorly studied entity, with a poorly defined prognosis and prevalence, associated with high morbidity and mortality, poor quality of life and high hospitalization rates.
Due to the limited evidence in this clinical field and the absence of contemporary studies, we decided to explore this line of research, determining epidemiological, clinical and prognostic aspects.
Analytical, retrospective observational cohort study, carried out in a National Medical Center.
The prevalence of three-vessel coronary artery disease not susceptible to revascularization was 12.2%, the majority were men (66%), over 65 years of age, with a high burden of comorbidities: pharmacological management consisted of beta blockers (91.5 %), antiplatelet aggregation (95.3%) and statins (95.3%): cardiovascular mortality was 9.4%, with myocardial infarction occurring in 10.4%: the predictor variables of mortality were chronic kidney disease, age over 70 years, insufficiency mitral valve.
Coronary artery disease of three vessels not susceptible to revascularization continues to be a frequent entity, with a high-risk clinical and anatomical profile, with a better contemporary prognosis despite the multiple gaps in knowledge that limit its understanding and treatment.
严重弥漫性冠状动脉疾病,其解剖结构不适合进行血运重建,这是一个研究较少的实体,预后和患病率定义不明确,与高发病率、高死亡率、低生活质量和高住院率相关。
由于该临床领域证据有限且缺乏当代研究,我们决定探索这一研究方向,确定其流行病学、临床和预后方面的情况。
在一家国家医疗中心进行分析性、回顾性观察队列研究。
无法进行血运重建的三支血管冠状动脉疾病患病率为12.2%,大多数为男性(66%),年龄超过65岁,合并症负担较重:药物治疗包括β受体阻滞剂(91.5%)、抗血小板聚集药物(95.3%)和他汀类药物(95.3%);心血管死亡率为9.4%,心肌梗死发生率为10.4%;死亡率的预测变量为慢性肾病、70岁以上年龄、二尖瓣功能不全。
无法进行血运重建的三支血管冠状动脉疾病仍然是一种常见疾病,具有高风险的临床和解剖学特征,尽管存在诸多知识空白限制了对其的理解和治疗,但当代预后较好。