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Am J Med:冠脉造影术后急性心肌损伤高达13.5%

2016-01-17 Seven L 译 MedSci原创

冠状动脉造影术对于冠状疾病的评估是安全的,现今全球范围内每年约有1200万名人进行冠状动脉造影术。研究者进行了一项研究,调查选择性冠状动脉造影的患者期心肌细胞损伤的频率和预测因素。该研究纳入了749名进行选择性冠状动脉造影的患者,研究者根据造影前后高敏心肌肌钙蛋白T (hs-cTnT)浓度的变化评估患者有无心肌细胞损伤,将 hs-cTnT值增高7 ng/L(满足相对变化>20%)以上定义为急性心肌

冠状动脉造影术对于冠状疾病的评估是安全的,现今全球范围内每年约有1200万名患者进行冠状动脉造影术。研究者进行了一项研究,调查选择性冠状动脉造影的患者期心肌细胞损伤的频率和预测因素。

该研究纳入了749名进行选择性冠状动脉造影的患者,研究者根据造影前后高敏心肌肌钙蛋白T (hs-cTnT)浓度的变化评估患者有无心肌细胞损伤。将 hs-cTnT值增高7 ng/L(满足相对变化>20%)以上定义为急性心肌细胞损伤。

研究数据显示,共有101例血管造影术后出现急性心肌细胞损伤(13.5%, 95%CI 11.1 to 16.2%)。研究者发现造影术后心肌细胞损伤与以下因素有关:主动脉瓣狭窄(OR 5.4 ; 95%CI 3.0 to 9.8; p<0.001)、年龄(OR 1.05; 95% CI 1.02-1.08; p<0.001)、女性(OR 3.5; 95% CI, 1.8-6.8; p<0.001)、造影剂体积(OR 1.006; 95% CI, 1.001-1.012; p=0.019(每10ml造影剂体积))、既往心肌病(OR 2.5; 95% CI, 1.0-6.0; p=0.045)、二尖瓣关闭不全(OR 2.3; CI 1.0-4.9; p=0.033)。而操作者经验和冠状动脉疾病与急性心肌损伤无关。

研究结果表明,冠状动脉造影术后并发心肌细胞损伤的发生率大约为1/8。性别、年龄、造影剂体积、心室疾病等是急性心肌损伤的预测因素,而本身的冠状动脉疾病与之无关。以后还需要更多的研究探究减少造影术后急性心肌细胞损伤的办法。

原始出处:

Kreutzinger P, Wildi K,et al.Incidence and predictors of cardiomyocyte injury in elective coronary angiography.Am J Med. 2016 Jan 4. pii: S0002-9343(15)30044-9.

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    2016-05-10 yzh399
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    2016-01-20 516009991

    学知识

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    2016-01-19 sodoo
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