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Clin Exp Rheumatol:大动脉炎患者冠脉受累对长期预后的影响

2020-05-30 xiangting MedSci原创

冠脉受累是TAK患者长期预后不良的重要预测指标。年龄大和V型血管造影分类有助于确定有冠脉受累的TAK患者。

这项研究旨在确定大动脉炎患者(TAK)冠脉受累的预测因素,并确定冠脉受累对长期结局的影响。

这项回顾性队列研究于1990年至2018年在一个三级中心对TAK患者进行血管造影或CT血管造影冠脉评估。分析了冠脉受累的危险因素以及总生存率、无心血管事件生存率和无复发生存率的预测因素。

中位随访时间4.3年(IQR 2.8–7.1)。在130例连续性TAK患者中,71例(54.6%)有冠脉受累。多因素分析显示,年龄(OR:每10年增加1.537,95%CI:1.176-2.009,p=0.002)和V型血管造影分类(OR:3.449,95%CI:1600-7.437,p=0.002)是冠脉受累的独立预测因子。冠脉受累(HR:8.358,95%CI:1.887–37.033,p=0.015)、左心室收缩功能障碍(HR:3.889,95%CI:1.467–10.311,p=0.006)和主动脉瓣返流(HR:3.373, 95%CI:1.209–9.408,p=0.020)是总体生存率的独立预测因子。此外,冠脉受累和基线活动性疾病与主要心血管事件(分别为HR:10.333,95%CI:2.326–45.906,p=0.017;HR:7.084,95%CI:1.677–29.914,p=0.008)和复发增多独立相关(分别为HR:5.186,95%CI:2.381-11.295,p<0.001;HR:5.694,95%CI:2.022-16.031,p=0.001)。没有任何免疫抑制疗法与心血管事件增多独立相关(HR:2.560,95%CI:1.15-1.550,p=0.002)。

冠脉受累是TAK患者长期预后不良的重要预测指标。年龄大和V型血管造影分类有助于确定有冠脉受累的TAK患者。

原始出处:

H. Wang. Impact of coronary involvement on long-term outcomes in patients with Takayasu's arteritis. Clin Exp Rheumatol. 2020

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    2020-11-13 xsm927
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