摘要
目的探讨主动脉瓣钙化(AVC)对急性冠状动脉综合征(ACS)经皮冠状动脉介入治疗(PCI)术后患者临床特征及预后的影响。方法对住院行PCI治疗的1 100例患者,连续入选其中符合纳入标准的研究对象174例,依据超声心动图检查评估主动脉瓣是否钙化分为ACS合并AVC组(简称AVC组,68例)和单纯ACS组(简称对照组106例)。收集患者的基线资料及所有临床资料,建立冠状动脉造影数据库,规律随访,进行预后分析。结果AVC组血脂异常(77.9%比38.7%,P<0.001)、2型糖尿病(47.1%比24.5%,P=0.002)、心律失常(37.3%比15.2%,P=0.002)比例显著高于对照组,差异均有统计学意义(P<0.05)。此外,AVC组Gensini评分显著高于对照组(P<0.001)。多因素Cox风险回归模型显示主动脉瓣钙化、心律失常、2型糖尿病,均为影响ACS患者预后不良的独立危险因素(HR分别为2.085、2.408、1.991,均P<0.05)。结论 ACS伴AVC患者合并血脂异常、2型糖尿病、心律失常等患病率高,AVC是ACS患者PCI术后远期预后不良的独立危险因素之一,无创经胸超声心动图评估主动脉瓣钙化可能成为ACS危险分层的重要临床指标。
Aim To investigate the effect of aortic valve calcification( AVC) on the clinical characteristics and prognosis of patients with acute coronary syndrome( ACS) undergone percutaneous coronary intervention( PCI).Methods A total of 68 ACS inpatients with echocardiographic AVC and 106 ACS controls without AVC undergone PCI were consecutively enrolled from January 2014 to January 2016 in the division of cardiology in our hospital. The clinical and angiographic data of the patients were collected and followed up for two years by two cardiology physicians. Results The prevalences of dyslipidemia( 77. 9% vs 38. 7%),type 2 diabetes mellitus( 47. 1% vs 24. 5%) and arrhythmia( 37.3% vs 15.2%) were significantly higher in the AVC group than the control goup( all P<0.05). In addition,the Gensini score was significantly higher in the AVC group than the control goup( P<0.05). The multivariate Cox regression model showed that aortic valve calcification,arrhythmia and type 2 diabetes mellitus were all independent worse prognostic risk factors of ACS( all P<0.05). Conclusions ACS patients with AVC undergone PCI presented with higher co-morbidities of dyslipidemia,type 2 diabetes mellitus and arrhythmia in this pilot study. AVC was associated with the severity of coronary stenosis and more stents implantation in ACS patients. Assessment of AVC by means of transthoracic echocardiography could be a valuable non-invasive method for risk stratification of ACS patients.
作者
刘佟
韩超
丁振江
李春华
王文丰
单伟超
张英
刘静怡
卜海伟
孙王乐贤
LIU Tong;HAN Chao;DING Zhenjiang;LI Chunhua;WANG Wenfeng;SHAN Weichao;ZHANG Ying;LIU Jingyi;BU Haiwei;SUN Lexian(Department of Cardiology,the Affiliated Hospital of Chengde Medical College &Chengde Cardiovascular Disease Institute, Chengde ,Hebei 067000,China)
出处
《中国动脉硬化杂志》
CAS
2019年第2期131-135,共5页
Chinese Journal of Arteriosclerosis
基金
河北省科技厅指令性计划项目(17277769D)
承德市科技局项目(20150147)
河北省2016年度医学科学研究重点课题计划项目(20160012)
