Circ-Heart Fail:新发心衰老年患者冠状动脉疾病检测的意义

2020-03-25 MedSci原创 MedSci原创

大多数新发心衰住院患者在住院期间或住院前后90天内均未接受CAD检测。LVEF≤40%的患者CAD检测率较高,但总体仍较低。

当前的指南建议对新发心衰(HF)患者的潜在心脏病和可逆性疾病进行评估,目前对新发HF患者冠状动脉疾病(CAD)的检测数据十分有限。

近日,心血管领域权威杂志Circ-Heart Fail上发表了一篇研究文章,研究人员使用了医疗保险索赔相关的HF登记中心数据进行了一项观察性队列研究。所有患者年龄≥65岁,在2009-2015年期间因新发HF住院。研究人员从登记处收集了受试者的左心室射血分数(LVEF)、既往HF病史和住院CAD检测结果,以及在HF住院前90天到住院后90天进行CAD检测的结果。

在17185例新发HF患者中,6672例(39%)接受了CAD检测,其中3997例(23%)受试者在住院期间接受了CAD检测。CAD的检测结果因LVEF的不同而异:HF患者中有53%的个体EF降低 (LVEF≤40%),HF患者中有42%的个体EF处于临界值 (LVEF为41%-49%),31%的HF患者EF正常 (LVEF≥50%)。经过多变量调整后,接受CAD检测的患者较未接受CAD检测的患者更年轻,且更有可能是男性、有吸烟史、高脂血症、心衰(射血分数降低或射血分数处于临界值(所有P<0.05)。

由此可见,大多数新发心衰住院患者在住院期间或住院前后90天内均未接受CAD检测。LVEF≤40%的患者CAD检测率较高,但总体仍较低。

原始出处:

Kyle D. O’Connor,et al.Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure Findings From Get With The Guidelines–Heart Failure.Circulation:heart failure. 2020.https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.120.006963

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    2020-03-27 zhaojie88
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    2020-03-27 slcumt

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