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Lancet:近红外光谱-血管内超声联合应用评估非梗阻性病变的未来风险

2021-03-13 MedSci原创 MedSci原创

对于冠状动脉病变患者,其非梗阻性病变经近红外光谱和血管内超声联合评估,可对患者未来不良心脏结局的风险做出更为准确的预测

尽管有越来越的初级和二级预防治疗手段,冠状动脉相关事件仍然是世界上主要的死亡原因。 急性冠状动脉综合征(ACS)最常见的是致病因素是在全身炎症的背景下,大的,富含脂质的动脉粥样硬化斑块的破坏和血栓形成。PROSPECT研究中,血管内超声显示斑块负担大(≥70%),管腔面积小(≤4.0mm)或二者兼有的血管造影轻度病变患者未来的冠状动脉事件风险较高。近红外光谱学(NIRS)和血管内超声是识别可能引起冠状动脉相关事件的非阻塞性斑块的有效手段。
近日研究人员考察了近红外光谱学和血管内超声联合使用对高危斑块和未来重大不良心脏事件风险患者(MACS)的识别效果。
PROSPECT II研究在丹麦、挪威和瑞典的14个大学医院和2个社区医院开展,过去4周内发生心肌梗死的患者参与,在治疗了所有的限流性冠状动脉病变后,采用NIRS和血管内超声导管联合进行三支血管成像。通过血管内超声识别非阻塞性高危斑块,其脂质含量由NIRS评估。研究的主要终点为MACS,包括心源性死亡,心肌梗死,不稳定心绞痛或进行性心绞痛。
 
898名患者参与研究,其中女性153人(17%),平均年龄63岁。总计识别了3629例非阻塞性高危斑块。在平均3.7年随访中,112人(13.2%)在4年内出现不良事件,上述患者通过联合手段总计识别了78个未经治疗的非阻塞性高危斑块,其中66个是造成患者不良事件的因素。高度脂质病变是预测非阻塞性高危斑块相关(OR=2.27)及特异性(OR=7.83)MACE事件的独立风险因素,较大的斑块负担也是预测非阻塞性高危斑块相关性MACE事件的独立风险因素。对于血管内超声显示较大,同时NIRS显示具有大的富含脂质核心的非阻塞性高危斑块,其4年内相关MACE风险为7%,对于存在多个双重风险因素斑块的患者,其4年内相关MACE风险为13.2%。
对于冠状动脉病变患者,其非梗阻性病变经近红外光谱和血管内超声联合评估,可对患者未来不良心脏结局的风险做出更为准确的预测
 
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    2021-11-12 howi
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1831070, encodeId=6c7f18310e0eb, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Nov 12 11:55:25 CST 2021, time=2021-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078259, encodeId=41e020e825956, content=<a href='/topic/show?id=2fd29428e24' target=_blank style='color:#2F92EE;'>#近红外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94287, encryptionId=2fd29428e24, topicName=近红外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Oct 13 17:55:25 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804434, encodeId=a5ff180443478, content=<a href='/topic/show?id=4047e71155a' target=_blank style='color:#2F92EE;'>#红外光谱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77115, encryptionId=4047e71155a, topicName=红外光谱)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Oct 27 12:55:25 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684189, encodeId=89aa16841890f, content=<a href='/topic/show?id=7425806967a' target=_blank style='color:#2F92EE;'>#联合应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80696, encryptionId=7425806967a, topicName=联合应用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091d28056243, createdName=s_pl2017, createdTime=Sat Oct 16 10:55:25 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819446, encodeId=3570181944685, content=<a href='/topic/show?id=ecb69948913' target=_blank style='color:#2F92EE;'>#非梗阻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99489, encryptionId=ecb69948913, topicName=非梗阻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Thu Jan 06 10:55:25 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034216, encodeId=c10010342161f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Mar 13 14:55:25 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=947874, encodeId=c4c994e874a3, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, 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=Sat Mar 13 14:48:01 CST 2021, time=2021-03-13, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1831070, encodeId=6c7f18310e0eb, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Nov 12 11:55:25 CST 2021, time=2021-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078259, encodeId=41e020e825956, content=<a href='/topic/show?id=2fd29428e24' target=_blank style='color:#2F92EE;'>#近红外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94287, encryptionId=2fd29428e24, topicName=近红外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Oct 13 17:55:25 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804434, encodeId=a5ff180443478, content=<a href='/topic/show?id=4047e71155a' target=_blank style='color:#2F92EE;'>#红外光谱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77115, encryptionId=4047e71155a, topicName=红外光谱)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Oct 27 12:55:25 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684189, encodeId=89aa16841890f, content=<a href='/topic/show?id=7425806967a' target=_blank style='color:#2F92EE;'>#联合应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80696, encryptionId=7425806967a, topicName=联合应用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091d28056243, createdName=s_pl2017, createdTime=Sat Oct 16 10:55:25 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819446, encodeId=3570181944685, content=<a href='/topic/show?id=ecb69948913' target=_blank style='color:#2F92EE;'>#非梗阻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99489, encryptionId=ecb69948913, topicName=非梗阻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Thu Jan 06 10:55:25 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034216, encodeId=c10010342161f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Mar 13 14:55:25 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=947874, encodeId=c4c994e874a3, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, 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=Sat Mar 13 14:48:01 CST 2021, time=2021-03-13, status=1, ipAttribution=)]
    2021-03-13 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1831070, encodeId=6c7f18310e0eb, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Nov 12 11:55:25 CST 2021, time=2021-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078259, encodeId=41e020e825956, content=<a href='/topic/show?id=2fd29428e24' target=_blank style='color:#2F92EE;'>#近红外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94287, encryptionId=2fd29428e24, topicName=近红外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Oct 13 17:55:25 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1804434, encodeId=a5ff180443478, content=<a href='/topic/show?id=4047e71155a' target=_blank style='color:#2F92EE;'>#红外光谱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77115, encryptionId=4047e71155a, topicName=红外光谱)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Oct 27 12:55:25 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684189, encodeId=89aa16841890f, content=<a href='/topic/show?id=7425806967a' target=_blank style='color:#2F92EE;'>#联合应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80696, encryptionId=7425806967a, topicName=联合应用)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091d28056243, createdName=s_pl2017, createdTime=Sat Oct 16 10:55:25 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819446, encodeId=3570181944685, content=<a href='/topic/show?id=ecb69948913' target=_blank style='color:#2F92EE;'>#非梗阻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99489, encryptionId=ecb69948913, topicName=非梗阻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Thu Jan 06 10:55:25 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034216, encodeId=c10010342161f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Mar 13 14:55:25 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=947874, encodeId=c4c994e874a3, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, 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=Sat Mar 13 14:48:01 CST 2021, time=2021-03-13, status=1, ipAttribution=)]
    2021-03-13 jyzxjiangqin

    好文章!

    0

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