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轻度至中度冠状动脉狭窄的诊断与管理的当前进展

Current Advancements in the Diagnosis and Management of Mild-to-moderate Coronary Stenosis.

作者信息

Guo Cuimei, Gao Haizhu, Bian Xinxin, Lin Nan, Gan Lijun, Chen Xueying

机构信息

Colleague of Clinical Medicine, Jining Medical University, 272067 Jining, Shandong, China.

Department of Cardiology, Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining Key Laboratory of Precise Therapeutic Research of Coronary Intervention, Affiliated Hospital of Jining Medical University, 272029 Jining, Shandong, China.

出版信息

Rev Cardiovasc Med. 2025 Aug 27;26(8):38822. doi: 10.31083/RCM38822. eCollection 2025 Aug.

Abstract

Coronary heart disease (CHD) is associated with increased morbidity and mortality. Acute cardiovascular events frequently occur in patients with coronary artery stenoses exceeding 70%. Although coronary revascularization can significantly improve ischemic symptoms, the inflection point for reducing mortality from CHD has yet to be reached. Therefore, the prevention and treatment of mild-to-moderate coronary artery stenosis should be given significant attention to more effectively reduce the incidence and mortality of acute events from CHD. Subsequently, a stenosis of less than 70% is used to characterize the incidence of mild to moderate coronary artery stenosis. While acute cardiovascular events caused by soft plaque and plaque rupture may not have a significant impact on hemodynamics, these events are detrimental and result in increased mortality. This review summarizes the methods available for detecting mild-to-moderate coronary artery stenoses, assessing risk, and understanding the mechanisms underlying adverse events. Moreover, this review proposes intervention strategies for preventing and treating mild to moderate coronary stenosis.

摘要

冠心病(CHD)与发病率和死亡率的增加相关。急性心血管事件频繁发生于冠状动脉狭窄超过70%的患者中。尽管冠状动脉血运重建可显著改善缺血症状,但降低冠心病死亡率的拐点尚未达到。因此,应高度重视轻至中度冠状动脉狭窄的防治,以更有效地降低冠心病急性事件的发生率和死亡率。随后,小于70%的狭窄用于表征轻至中度冠状动脉狭窄的发生率。虽然由软斑块和斑块破裂引起的急性心血管事件可能对血流动力学没有显著影响,但这些事件是有害的,并会导致死亡率增加。本综述总结了可用于检测轻至中度冠状动脉狭窄、评估风险以及了解不良事件潜在机制的方法。此外,本综述提出了预防和治疗轻至中度冠状动脉狭窄的干预策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a2e/12415760/23a3829eb634/2153-8174-26-8-38822-g1.jpg

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