JAHA:癌症病史的急性冠状动脉综合征患者斑块形态学特征和临床结局

2021-07-26 MedSci原创 MedSci原创

与没有癌症病史的患者相比,癌症病史患者ACS后的临床结局明显更差。那些既往有癌症病史的患者在ACS病变血管中的斑块侵蚀和钙化结节的发生率明显更高,这可能部分解释了他们更糟糕的临床结局。

尽管既往有癌症病史的患者急性冠状动脉综合征(ACS)风险要高出2到3倍,但这些患者中ACS犯罪斑块的形态特征及其与临床结局之间的关系仍然明确。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项回顾性、多中心、观察性队列研究纳入了连续就诊且接受光学相干断层扫描引导的急诊经皮冠状动脉介入治疗的ACS患者。患者分为无癌症病史、有癌症病史和目前接受抗癌治疗的患者。研究人员使用光学相干断层扫描将ACS罪犯病变分类为斑块破裂、斑块侵蚀或钙化结节。

当前癌症患者和伴有癌症病史的患者罪犯病变中斑块侵蚀频率显著高于无癌症病史患者(56.3% vs 61.7% vs 36.5%)。既往有癌症病史患者的钙化结节发生率显著高于当前癌症患者和无癌症病史患者(当前癌症患者:12.4% vs 无癌症病史患者:25.5% vs 癌症病史患者:12.6%,P<0.001)。

癌症病史与ACS罪犯病变中的非斑块破裂(斑块侵蚀或钙化结节)独立相关(比值比为4.00;P<0.001)。癌症病史与主要不良心血管事件独立相关(风险比[HR]为1.98;P=0.002)。ACS罪犯病变中的非斑块破裂与主要不良心血管事件独立相关(HR为1.60;P=0.011)。

由此可见,与没有癌症病史的患者相比,癌症病史患者ACS后的临床结局明显更差。那些既往有癌症病史的患者在ACS病变血管中的斑块侵蚀和钙化结节的发生率明显更高,这可能部分解释了他们更糟糕的临床结局。

原始出处:

Kosuke Tanimura.et al.Morphological Plaque Characteristics and Clinical Outcomes in Patients With Acute Coronary Syndrome and a Cancer History.JAHA.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.020243

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    2021-07-28 zhaohui6731
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    2021-07-27 smart Ren

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