Eur Heart J:早期冠状动脉造影和急性缺血性心衰结局

2021-07-31 MedSci原创 MedSci原创

早期冠状动脉造影与可能发生缺血的急性HF患者的全因死亡率、心血管死亡、心衰再入院率和冠脉血运重建率降低相关。

虽然心肌缺血在心力衰竭(HF)的发病机制中起主要作用,但急性HF期间冠状动脉造影的指征尚未明确。

近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在明确急性HF住院期间的早期冠状动脉造影与2年死亡率、心血管死亡、HF再入院和冠状动脉血运重建之间的关联。

在两阶段抽样过程中,研究人员确定了到70名在安大略省急诊科就诊的急性HF患者(2010年4月至2013年3月),并使用行政数据库确定他们是否在就诊后14天内进行了早期冠状动脉造影。在审查临床记录后,研究人员将急性缺血性HF队列定义为伴有至少一个提示为缺血性心脏病因素的患者,包括既往心肌梗死、肌钙蛋白升高或就诊时心绞痛。研究人员对接受血管造影术的患者进行了采样,并使用治疗逆概率加权(IPTW)来调整基线差异。

各组死亡的累积发生率

在7239名急性HF患者中,2994名患者符合纳入标准[中位年龄为75(四分位距65-83)岁;40.9%为女性]。1567名(52.3%)患者进行了早期血管造影,并与较低的全因死亡率[风险比(HR)为0.74,95%置信区间(CI)为0.61-0.90,P=0.002]、心血管死亡(HR为0.72,95%CI为0.56-0.93,P=0.012)和HF再入院(HR为0.84,95%CI为0.71-0.99,P=0.042)相关。那些接受早期血管造影术的患者在1年内接受经皮冠状动脉介入治疗(HR为2.58,95%CI为1.73-3.86,P<0.001)和冠状动脉旁路移植术(HR为2.94,95%CI为1.75-4.93,P<0.2001)的比率更高。

由此可见,早期冠状动脉造影与可能发生缺血的急性HF患者的全因死亡率、心血管死亡、心衰再入院率和冠脉血运重建率降低相关。

原始出处:

Leah B Kosyakovsky.et al.Early invasive coronary angiography and acute ischaemic heart failure outcomes.European Heart Journal.2021.https://doi.org/10.1093/eurheartj/ehab423

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    2022-01-06 Doctoryangbai

    及时行冠脉造影非常必要

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1181365, encodeId=32bc11813658b, content=及时行冠脉造影非常必要, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Thu Jan 06 14:48:44 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037283, encodeId=2274203e283ad, content=<a href='/topic/show?id=8333e9371db' target=_blank style='color:#2F92EE;'>#缺血性心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79371, encryptionId=8333e9371db, topicName=缺血性心衰)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Jr8S1dfvNyP22t32IFDXJXnpd5AGlDibiajL5cl3pxj7OPCeAeibLhzOmZn5Q2Oicc6uKOCnxGNOggdLtI3hIW7huQ/132, createdBy=66e52500008, createdName=Tamikia, createdTime=Sat Dec 18 17:03:43 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893408, encodeId=d78e1893408e8, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Wed Oct 27 08:03:43 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004906, encodeId=5d8c100490619, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Tue Aug 03 15:46:06 CST 2021, time=2021-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357752, encodeId=4472135e75227, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447162, encodeId=c7fd144e1625a, content=<a href='/topic/show?id=97e1309105d' target=_blank style='color:#2F92EE;'>#冠状动脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30910, encryptionId=97e1309105d, topicName=冠状动脉造影)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/RNJfsfhsEic2avjCncr2VWPKViaUUV8QbHGvDicvYf6AiaQxTlhBo1TZBFuZQq80ia2pejj3QwjOy03Hyt1z1b3DQpA/132, createdBy=2e4c5322318, createdName=mhzhuang@stu.e, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494181, encodeId=19c31494181fb, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563497, encodeId=e4d4156349eb8, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=)]
    2021-08-03 Doctoryangbai

    学习了

    0

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    2021-08-02 zhaojie88
  6. [GetPortalCommentsPageByObjectIdResponse(id=1181365, encodeId=32bc11813658b, content=及时行冠脉造影非常必要, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Thu Jan 06 14:48:44 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037283, encodeId=2274203e283ad, content=<a href='/topic/show?id=8333e9371db' target=_blank style='color:#2F92EE;'>#缺血性心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79371, encryptionId=8333e9371db, topicName=缺血性心衰)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Jr8S1dfvNyP22t32IFDXJXnpd5AGlDibiajL5cl3pxj7OPCeAeibLhzOmZn5Q2Oicc6uKOCnxGNOggdLtI3hIW7huQ/132, createdBy=66e52500008, createdName=Tamikia, createdTime=Sat Dec 18 17:03:43 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893408, encodeId=d78e1893408e8, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Wed Oct 27 08:03:43 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004906, encodeId=5d8c100490619, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Tue Aug 03 15:46:06 CST 2021, time=2021-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357752, encodeId=4472135e75227, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447162, encodeId=c7fd144e1625a, content=<a href='/topic/show?id=97e1309105d' target=_blank style='color:#2F92EE;'>#冠状动脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30910, encryptionId=97e1309105d, topicName=冠状动脉造影)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/RNJfsfhsEic2avjCncr2VWPKViaUUV8QbHGvDicvYf6AiaQxTlhBo1TZBFuZQq80ia2pejj3QwjOy03Hyt1z1b3DQpA/132, createdBy=2e4c5322318, createdName=mhzhuang@stu.e, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494181, encodeId=19c31494181fb, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563497, encodeId=e4d4156349eb8, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1181365, encodeId=32bc11813658b, content=及时行冠脉造影非常必要, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Thu Jan 06 14:48:44 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037283, encodeId=2274203e283ad, content=<a href='/topic/show?id=8333e9371db' target=_blank style='color:#2F92EE;'>#缺血性心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79371, encryptionId=8333e9371db, topicName=缺血性心衰)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Jr8S1dfvNyP22t32IFDXJXnpd5AGlDibiajL5cl3pxj7OPCeAeibLhzOmZn5Q2Oicc6uKOCnxGNOggdLtI3hIW7huQ/132, createdBy=66e52500008, createdName=Tamikia, createdTime=Sat Dec 18 17:03:43 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893408, encodeId=d78e1893408e8, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Wed Oct 27 08:03:43 CST 2021, time=2021-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004906, encodeId=5d8c100490619, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Tue Aug 03 15:46:06 CST 2021, time=2021-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357752, encodeId=4472135e75227, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447162, encodeId=c7fd144e1625a, content=<a href='/topic/show?id=97e1309105d' target=_blank style='color:#2F92EE;'>#冠状动脉造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30910, encryptionId=97e1309105d, topicName=冠状动脉造影)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/RNJfsfhsEic2avjCncr2VWPKViaUUV8QbHGvDicvYf6AiaQxTlhBo1TZBFuZQq80ia2pejj3QwjOy03Hyt1z1b3DQpA/132, createdBy=2e4c5322318, createdName=mhzhuang@stu.e, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494181, encodeId=19c31494181fb, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563497, encodeId=e4d4156349eb8, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 02 07:03:43 CST 2021, time=2021-08-02, status=1, ipAttribution=)]
    2021-08-02 sodoo
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    2021-08-02 slcumt

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COVID-19住院患者AKI与主要不良心血管事件和全因死亡率之间存在显著的相关性。

Stroke:COVID-19期间缺血性卒中患者的治疗和结局

与COVID-19之前的AIS患者相比,在COVID-19期间发生的AIS患者得到了相似质量的治疗,并且经历了类似的风险调整结局。这些结果表明,在COVID-19大流行期间,美国卒中治疗仍很稳健健。