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外周动脉疾病对急性冠状动脉综合征结局的影响。

Impact of Peripheral Arterial Disease on Outcomes of Acute Coronary Syndrome.

作者信息

Gherasie Flavius-Alexandru, Popescu Mihaela-Roxana, Bartos Daniela

机构信息

Department of Cardiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Dr. Bagdasar-Arseni, Emergency Clinical Hospital, 050474 Bucharest, Romania.

出版信息

Maedica (Bucur). 2024 Sep;19(3):470-477. doi: 10.26574/maedica.2024.19.3.470.

DOI:10.26574/maedica.2024.19.3.470
PMID:39553365
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11565134/
Abstract

BACKGROUND

Peripheral artery disease (PAD) refers to the extracardiac localization of atherosclerotic disease, generally in arteries that vascularize the lower limbs. More than 50% of patients with PAD also have coronary artery disease (CAD). There are concerns about possible differences in mortality rates among hospitalized patients and the need for immediate revascularization during hospital stay across different types of acute coronary syndrome (ACS) when PAD is present.

METHODS

This was a retrospective study that included 100 patients admitted with ACS between October 2019 and May 2022. Participants were divided into two groups: those with ACS and PAD (n=32) and those without PAD (n=68). We used the SYNTAX score to evaluate the severity of coronary artery disease, the amount of contrast and dose area product (DAP) dosage per patient during the procedure and how these factors vary.

RESULTS

There was a 6.8 higher average SYNTAX score among patients with ACS and PAD (p=0.034), which could negatively affect their prognosis. In addition, there was a 12.7-point increase in the SYNTAX score for patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) and PAD (p=0.008). Patients with ACS and concomitant PAD were more likely to require complete revascularization of the left main disease.

CONCLUSION

Patients with PAD and concomitant ACS have more severe CAD, with more frequent involvement of the left main artery than those without PAD.

摘要

背景

外周动脉疾病(PAD)是指动脉粥样硬化疾病的心脏外定位,通常发生在为下肢供血的动脉中。超过50%的PAD患者同时患有冠状动脉疾病(CAD)。当存在PAD时,对于住院患者死亡率的可能差异以及不同类型急性冠状动脉综合征(ACS)住院期间立即进行血运重建的必要性存在担忧。

方法

这是一项回顾性研究,纳入了2019年10月至2022年5月期间因ACS入院的100例患者。参与者被分为两组:患有ACS和PAD的患者(n = 32)和未患有PAD的患者(n = 68)。我们使用SYNTAX评分来评估冠状动脉疾病的严重程度、手术过程中每位患者的造影剂用量和剂量面积乘积(DAP)剂量,以及这些因素如何变化。

结果

患有ACS和PAD的患者平均SYNTAX评分高出6.8分(p = 0.034),这可能对其预后产生负面影响。此外,非ST段抬高型急性冠状动脉综合征(NSTEACS)和PAD患者的SYNTAX评分增加了12.7分(p = 0.008)。患有ACS并伴有PAD的患者更有可能需要对左主干疾病进行完全血运重建。

结论

患有PAD并伴有ACS的患者CAD更严重,与未患有PAD的患者相比,左主干动脉受累更频繁。