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Heart：并发于感染性心内膜炎的冠状动脉事件！

2017-06-23 xing.T MedSci原创

IEACS事件
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由此可见，ACS是感染性心内膜炎的一种罕见并发症，但其与心衰风险增加和高死亡率有关。

急性冠状动脉综合征（ACS）是一种罕见的感染性心内膜炎（IE）并发症。迄今为止，只有病例报告和小型研究发表。近日，在心脏病领域权威杂志Heart上发表了一篇研究文章，研究人员报道了最大系列的感染性心内膜炎并发的ACS，研究人员的目的是描述与感染性心内膜炎相关的ACS发病率和发病机制，评估其预后影响，并描述它们的临床治疗管理。

在两中心的前瞻性观察性队列研究中，研究人员前瞻性地纳入了所有明确诊断的患者。研究人员对ACS患者的发病率、发病机制及预后进行了研究分析。

在1210例连续就诊的经确诊为感染性心内膜炎的患者中，26例（2.2%）患者发展为ACS。23例（88%）患者发展为冠状动脉栓塞。两例患者因脓肿或假性动脉瘤导致冠状动脉受挤压，一例患者因一个较大的赘生物而导致其瓣膜口和左冠状动脉开口阻塞。十九例（73%）ACS患者发生心力衰竭，并且这一并发症的发生率是无ACS患者的2.5倍（P＜0.0001）。在ACS人群中，其死亡率是没有ACS人群的两倍。

由此可见，ACS是感染性心内膜炎的一种罕见并发症，但其与心衰风险增加和高死亡率有关。

原始出处：

Virginie Roux,et al. Coronary events complicating infective endocarditis. Heart. 2017. http://dx.doi.org/10.1136/heartjnl-2017-311624

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    2018-03-07 charl1234575

    #感染性#

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    2018-05-04 丁鹏鹏

    #并发#

    0

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createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Sat Aug 19 03:29:00 CST 2017, time=2017-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757801, encodeId=4e211e57801ca, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Fri May 04 20:29:00 CST 2018, time=2018-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220029, encodeId=e4c2220029b0, content=不错的文章值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jul 08 19:18:30 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216207, encodeId=55b421620e4d, content=并发感染性心内膜炎的冠脉事件。, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Jun 28 07:24:48 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215125, encodeId=aa8321512504, content=感谢小编为我们精心准备了如此精辟的精神大餐，小编辛苦了，点个赞吧！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562591, encodeId=004615625914d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-07-08 虈亣靌

    不错的文章值得学习

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-28 jyzxjiangqin

    并发感染性心内膜炎的冠脉事件。

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-25 ylzr123

    感谢小编为我们精心准备了如此精辟的精神大餐，小编辛苦了，点个赞吧！

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-25 zhaojie88

    #心内膜炎#

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-25 zhaojie88

    #ART#

    0

  9. 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562591, encodeId=004615625914d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-25 slcumt

    #HEART#

    0

  10. 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562591, encodeId=004615625914d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Jun 25 07:29:00 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214864, encodeId=de88214864dc, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Sat Jun 24 17:30:38 CST 2017, time=2017-06-24, status=1, ipAttribution=)]
    2017-06-24 135****7952平儿

    学了。。。。。。。。。。

    0

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Heart：高龄感染性心内膜炎患者有何不同？

由此可见，高龄患者的IE是一个与年轻人有所不同的疾病，肠球菌是最常见的感染微生物，并且死亡率较年轻的患者要高。ESC建议高龄患者进行手术治疗要比年轻患者少，导致了有手术适应症的患者没有手术而死亡率急剧增加，而手术患者预后良好。这些结果表明手术在高龄IE患者中没有被充分利用。

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