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JACC子刊:冠脉迂曲病变可增加支架置入术后心血管事件死亡率!

2021-03-02 MedSci原创 MedSci原创

近期发布于JACC子刊上的一篇报道发现冠脉迂曲病变可增加心血管事件死亡率!

冠脉迂曲是一种常见的冠脉造影表现,与球囊血管成形术后早期和晚期主要不良事件的发生率增加有关,但是冠状动脉迂曲对于支架置入术后的临床结果的影响鲜有研究,近期发布于JACC子刊上的一篇报道发现冠脉迂曲病变可增加心血管事件死亡率

该研究纳入6项前瞻性随机对照试验患者的资料,分析不同形态的冠状动脉病变在支架植入术后30天和5年的结果,根据冠脉是否为中度/重度迂曲病变进行分组,主要终点是靶血管衰竭(TVF;心血管相关性死亡、TV-MI:靶血管相关心肌梗死、ID-TVR:靶血管血运重建),研究共纳入6951例患者中,其中729例(10.5%)冠脉为中、重度迂曲病变并行支架植入术。

在30天时,冠脉中/重度迂曲病变患者中TVF更常见(3.8% vs 2.4%,风险比:1.64,95%CI:1.09-2.46;p=0.02),这一差异是由冠脉中/重度迂曲病变患者中TV-MI的较高导致。

5年后,由于冠脉中/重度迂曲病变患者中TV-MI(P=0.003)和ID-TVR(P=0.003)较高的发生率,冠脉中/重度迂曲病变患者的TVF仍较高(p=0.003)。

另外冠脉中/重度迂曲病变患者与无中度/重度迂曲病变的患者相比,支架内血栓发生率也更高(1.9% vs 1.0%,风险比:1.86,95%CI:1.02-3.39;p=0.04)。调整基线协变量后,5年后中度/重度血管迂曲病变患者与TV-MI和ID-TVR独立相关(p=0.04)。

冠脉迂曲病变TVF发生率

总的来说在冠状动脉中、重度迂曲病变的血管中植入支架与心血管事件死亡率增加有关,且是由靶血管相关心肌梗死和靶血管血运重建的发生率增高导致的。

原始出处:

Konigstein M, Ben-Yehuda O, Redfors B, Mintz GS, Madhavan MV, Golomb M, McAndrew T, Zhang Z, Kandzari DE, Hermiller JB, Leon MB, Stone GW. Impact of Coronary Artery Tortuosity on Outcomes Following Stenting: A Pooled Analysis From 6 Trials. JACC Cardiovasc Interv. 2021 Feb 20:S1936-8798(20)32505-X. doi: 10.1016/j.jcin.2020.12.027. Epub ahead of print. PMID: 33640388.

 

 

 

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    2021-07-29 口口王木木

    学习了

    0

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    2021-06-08 口口王木木

    学习了,谢谢

    0

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    2021-04-22 hbwxf
  5. [GetPortalCommentsPageByObjectIdResponse(id=1766707, encodeId=81f11e66707af, content=<a href='/topic/show?id=fc89e965910' target=_blank style='color:#2F92EE;'>#置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79659, encryptionId=fc89e965910, topicName=置入术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bd637855499, createdName=小小小向日葵, createdTime=Fri May 14 10:39:32 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003532, encodeId=f89d1003532ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230114/bc8f9e242ba04619a889c6a2e67ce2c1/f4da081d14584973854d77cd79b42c5b.jpg, createdBy=41181970428, createdName=口口王木木, createdTime=Thu Jul 29 09:38:49 CST 2021, time=2021-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=971915, encodeId=b63a9e191518, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230114/bc8f9e242ba04619a889c6a2e67ce2c1/f4da081d14584973854d77cd79b42c5b.jpg, createdBy=41181970428, createdName=口口王木木, createdTime=Tue Jun 08 17:46:40 CST 2021, time=2021-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854880, encodeId=383e1854880b7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu Apr 22 15:39:32 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643732, encodeId=1e881643e3232, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Sat Jul 10 14:39:32 CST 2021, time=2021-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946033, encodeId=d56d94603371, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Mar 06 20:42:56 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945628, encodeId=57c2945628ce, content=增加支架植入术后心血管事件的死亡率, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Fri Mar 05 08:51:40 CST 2021, time=2021-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326735, encodeId=d2511326e3510, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Mar 04 06:39:32 CST 2021, time=2021-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944891, encodeId=ff48944891ff, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, 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=Tue Mar 02 19:01:32 CST 2021, time=2021-03-02, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1766707, encodeId=81f11e66707af, content=<a href='/topic/show?id=fc89e965910' target=_blank style='color:#2F92EE;'>#置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79659, encryptionId=fc89e965910, topicName=置入术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bd637855499, createdName=小小小向日葵, createdTime=Fri May 14 10:39:32 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003532, encodeId=f89d1003532ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230114/bc8f9e242ba04619a889c6a2e67ce2c1/f4da081d14584973854d77cd79b42c5b.jpg, createdBy=41181970428, createdName=口口王木木, createdTime=Thu Jul 29 09:38:49 CST 2021, time=2021-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=971915, encodeId=b63a9e191518, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230114/bc8f9e242ba04619a889c6a2e67ce2c1/f4da081d14584973854d77cd79b42c5b.jpg, createdBy=41181970428, createdName=口口王木木, createdTime=Tue Jun 08 17:46:40 CST 2021, time=2021-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854880, encodeId=383e1854880b7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Thu Apr 22 15:39:32 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643732, encodeId=1e881643e3232, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Sat Jul 10 14:39:32 CST 2021, time=2021-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946033, encodeId=d56d94603371, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Mar 06 20:42:56 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945628, encodeId=57c2945628ce, content=增加支架植入术后心血管事件的死亡率, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Fri Mar 05 08:51:40 CST 2021, time=2021-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326735, encodeId=d2511326e3510, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Mar 04 06:39:32 CST 2021, time=2021-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944891, encodeId=ff48944891ff, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, 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=Tue Mar 02 19:01:32 CST 2021, time=2021-03-02, status=1, ipAttribution=)]
    2021-03-06 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2021-03-05 科研科研科研

    增加支架植入术后心血管事件的死亡率

    0

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    2021-03-02 jyzxjiangqin

    好文章!

    0

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