JAHA:动脉-动脉栓塞性ST段抬高型心肌梗死的患病率、特征和预后

2020-12-01 MedSci原创 MedSci原创

AAEMI是ST段抬高型心肌梗死的罕见原因,并具有独特的斑块形态特征,包括破裂部位较大的管腔面积,阻塞部位较小的管腔面积。

急性冠状动脉综合征的主要潜在机制是斑块破裂、斑块糜烂和钙化结节。动脉-动脉栓塞性心肌梗死(AAEMI)的定义为ST段抬高性心肌梗塞是由动脉近端破裂斑块形成的血栓迁移引起的。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项研究旨在通过光学相干断层扫描技术来探究AAEMI的患病率和临床特征。

这项研究回顾性分析了297例ST段抬高型心肌梗死患者,这些患者在经皮冠状动脉介入治疗之前接受了光学相干断层扫描。根据光学相干断层扫描的结果,将患者分为斑块破裂、斑块侵蚀、钙化结节和AAEMI4个组。

AAEMI的患病率为3.4%,AAEMI患者中有60%的罪犯血管是右冠状动脉。与斑块破裂、斑块侵蚀和钙化结节相比,AAEMI组病变部位的最小管腔面积更大(4.0 mm2 [四分位间距(IQR)为2.2–4.9] vs. 1.0 mm2 [IQR为0.8–1.3] vs. 1.0 mm2 [ IQR为0.8-1.2]与1.1 mm2 [IQR为0.7-1.6],P<0.001)。

与斑块破裂患者相比,AAEMI患者破裂部位的管腔面积更大(4.4 mm2 [IQR为2.5-6.7] vs. 1.5 mm2 [IQR为1.0-2.4],P<0.001)。在AAEMI患者中,闭塞部位的最小内腔中位数为1.2 mm2(IQR为1.0-2.1),其中40%的患者采用了非支架植入治疗,并且3年主要不良心脏事件发生率为0%。

由此可见,AAEMI是ST段抬高型心肌梗死的罕见原因,并具有独特的斑块形态特征,包括破裂部位较大的管腔面积,阻塞部位较小的管腔面积。

原始出处:

Masahiro Takahata.et al.Prevalence, Features, and Prognosis of Artery‐to‐Artery Embolic ST‐Segment–Elevation Myocardial Infarction: An Optical Coherence Tomography Study.J AM HEART ASSOC.2020.https://www.ahajournals.org/doi/10.1161/JAHA.120.018731

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    2020-12-03 zhaohui6731
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    2020-12-03 gdsun
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    2020-12-03 hyf035
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    2020-12-01 刘煜

    阅读谢谢发现

    0

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