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肌钙蛋白水平升高但无阻塞性罪犯病变或疑似非阻塞性冠状动脉心肌梗死患者的年龄差异——超过十年的长期数据

Age Variation in Patients with Troponin Level Elevation Without Obstructive Culprit Lesion or Suspected Myocardial Infarction with Non-Obstructive Coronary Arteries-Long-Term Data Covering over Decade.

作者信息

Abumayyaleh Mohammad, Schlettert Clara, Materzok Daniel, Mügge Andreas, Hamdani Nazha, Akin Ibrahim, Aweimer Assem, El-Battrawy Ibrahim

机构信息

Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.

European Center for AngioScience (ECAS) and DZHK (German Center for Cardiovascular Research (DZHK)), Partner Site, 68167 Mannheim, Germany.

出版信息

J Clin Med. 2024 Dec 17;13(24):7685. doi: 10.3390/jcm13247685.

Abstract

Troponin level elevation without an obstructive culprit lesion is caused by heterogenous entities. The effect of aging on this condition has been poorly investigated. After screening 24,775 patients between 2010 and 2021, this study included a total of 373 patients with elevated troponin levels without an obstructive culprit lesion or suspected myocardial infarction with non-obstructive coronary arteries (MINOCAs) categorized into four age groups containing 78 patients (<51 years), 72 patients (51-60 years), 81 patients (61-70 years), and 142 patients (>70 years). This study analyzed the baseline characteristics, the in-hospital complications, in-hospital mortality, and the long-term outcomes. The older patients exhibited a higher rate of major adverse cardiovascular in-hospital events than those of the other age groups (15.4% in the <51-year-old group vs. 36.1% in the 51-60-year-old group vs. 33.3% in the 61-70-year-old group vs. 47.2% in the >70-year-old group; < 0.001). However, the rate of non-sustained ventricular tachycardia (nsVT) was higher in the 51-60-year-old patients than those of the other age groups (5.6% in the 51-60-year-old group vs. 1.3% in the 61-70-year-old group vs. 0.7% in the >70-year-old group; = 0.027). At the 11-year follow-up, cardiovascular mortality was higher among the older patients compared to that of the younger patients (3.9% in the 61-70-year-old group vs. 4.2% in the >70-year-old group, = 0.042), while non-cardiovascular mortality was comparable between the age groups. The older patients with troponin level elevation without an obstructive culprit lesion experienced a higher incidence of major adverse cardiovascular events during hospitalization compared to that of the younger groups. Additionally, higher cardiovascular mortality rates were revealed in the older patients at a long-term follow-up.

摘要

肌钙蛋白水平升高但无阻塞性罪犯病变是由多种不同病因引起的。衰老对这种情况的影响尚未得到充分研究。在对2010年至2021年间的24775名患者进行筛查后,本研究共纳入了373例肌钙蛋白水平升高且无阻塞性罪犯病变或疑似非阻塞性冠状动脉心肌梗死(MINOCA)的患者,分为四个年龄组,分别为78例(<51岁)、72例(51 - 60岁)、81例(61 - 70岁)和142例(>70岁)。本研究分析了基线特征、院内并发症、院内死亡率和长期预后。老年患者院内主要不良心血管事件发生率高于其他年龄组(<51岁组为15.4%,51 - 60岁组为36.1%,61 - 70岁组为33.3%,>70岁组为47.2%;<0.001)。然而,51 - 60岁患者非持续性室性心动过速(nsVT)的发生率高于其他年龄组(51 - 60岁组为5.6%,61 - 70岁组为1.3%,>70岁组为0.7%;P = 0.027)。在11年的随访中,老年患者的心血管死亡率高于年轻患者(61 - 70岁组为3.9%,>70岁组为4.2%,P = 0.042),而非心血管死亡率在各年龄组之间相当。与年轻组相比,肌钙蛋白水平升高且无阻塞性罪犯病变的老年患者在住院期间发生主要不良心血管事件的发生率更高。此外,在长期随访中,老年患者的心血管死亡率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340d/11676906/fd28427ceb33/jcm-13-07685-g001.jpg

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