Int J Cardiol:接受冠状动脉血运重建的糖尿病和多支血管病变患者急性肾损伤的发生率、决定因素和影响

2019-06-14 xing.T MedSci原创

由此可见,尽管接受CABG的患者AKI风险较高,但无论血运重建策略如何,AKI对MACE的影响都很大。确定有AKI风险的患者的预防策略有助于减轻这种并发症的长期影响。

急性肾损伤(AKI)在冠状动脉血运重建的糖尿病和多支冠状动脉疾病患者中的发病率和预后意义尚不清楚。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,目前的分析纳入了FREEDOM试验中随机分配接受PCI与CABG治疗的患者。研究人员试图评估AKI及其预测因子对多发性冠状动脉疾病患者PCI和CABG的影响。

研究人员对FREEDOM试验进行了预先指定的亚组分析,以根据血运重建策略评估可AKI的发生率、相关性和影响。使用多变量Logistic回归确定AKI预测因子,并使用Cox回归评估AKI与结局之间的关联。主要终点是5年随访时全因死亡、卒中心肌梗死复合事件的发生。

与PCI相比,CABG患者(15.6%)发生KI的频率更高(9.1%)(p<0.001)。 AKI与5年时主要心血管事件(MACE)的高风险相关(34.6% vs. 20.5%,p<0.001),无论CABG(HR=2.18 95%CI为1.44-3.31,p≤0.001)或PCI(HR=2.08 95%CI为1.35-3.21,p<0.0001),这种效应仍然明显且显著。血运重建方法和AKI之间存在非显著的相互作用(p=0.89),支持AKI是两种血运重建方法中的重要的危险因素。

由此可见,尽管接受CABG的患者AKI风险较高,但无论血运重建策略如何,AKI对MACE的影响都很大。确定有AKI风险的患者的预防策略有助于减轻这种并发症的长期影响。 

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  5. 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  6. 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  7. 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  8. 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  9. 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createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Jun 14 23:20:25 CST 2019, time=2019-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042522, encodeId=6b7b104252295, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Jun 14 15:17:00 CST 2019, time=2019-06-14, status=1, ipAttribution=)]
    2019-06-14 天地飞扬

    学习,谢谢分享!

    0

  10. 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    2019-06-14 misszhang

    谢谢MedSci提供最新的资讯

    0