JACC:“虚弱”的量化在主动脉瓣置换术患者中的研究

2017-08-02 MedSci MedSci原创

虚弱是一种老年性的"综合征",对经导管主动脉瓣置换术(TAVR)或经外科主动脉瓣置换术(SAVR)后的恢复存在潜在的影响。然而,受到对虚弱量化的限制,临床上很难开展相关研究。近日,在国际心血管权威杂志JACC上发表了一篇旨在比较7种不同的虚弱测量尺度来预测TAVR或SAVR术后预后不良结局的临床研究。本研究纳入了2012年至2016年来自3个国家14个研究中心的TAVR和SAVR术后的老年患者,并

虚弱是一种老年性的"综合征",对经导管主动脉瓣置换术(TAVR)或经外科主动脉瓣置换术(SAVR)后的恢复存在潜在的影响。然而,受到对虚弱量化的限制,临床上很难开展相关研究。近日,在国际心血管权威杂志JACC上发表了一篇旨在比较7种不同的虚弱测量尺度来预测TAVR或SAVR术后预后不良结局的临床研究。

本研究纳入了2012年至2016年来自3个国家14个研究中心的TAVR和SAVR术后的老年患者,并对其一下几个虚弱的测量进行比较:弗里德、弗里德+、罗克伍德、SPPB、伯尔尼、哥伦比亚和EFT。主要终点事件是全因死亡率和1年后残疾率。最终,本研究共纳入1020名平均年龄为82岁的患者,根据不同虚弱测量尺度,患者的虚弱发生率为26%-68%。EFT是预测1年死亡率最有效的测量方法([OR]: 3.72; 95% [CI]: 2.54-5.45)。此外,EFT同样是1年残疾率(OR: 2.13; 95% CI: 1.57-2.87)和30天死亡率(OR: 3.29; 95% CI: 1.73-6.26)的最有效测量手段。

研究结果表明,虚弱是TAVR和SAVR术后死亡和残疾的危险因素,下肢无力、认知功能障碍、贫血和低蛋白血症的联合评估被推荐为虚弱的量化指标。

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    2017-09-28 yxch48
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    2017-10-20 hbwxf
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    2017-08-02 hhh678

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目前,通过敏感度高的检测手段可以检测无明显临床心梗症状病人的肌酐蛋白I和T(hs-cTnI, hs-cTnT)的含量。近日,在国际心血管权威杂志JACC上发表了一篇旨在评估初次干预的患者的心血管疾病(CVD)预后与心脏肌酐蛋白浓度相关性的临床研究。本研究搜索并分析了PubMed, Web of Science,和EMBASE数据库截至2016年9月份发表的关于心脏肌钙蛋白浓度和心血管疾病预后(比如

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老年女性是冠心病和心衰的高发人群。现在高灵敏的检测手段可以检测出急性冠脉综合征患者微量的肌钙蛋白I(hsTnI)。近日,在国际心血管权威杂志JAHA上发表了一篇旨在评估年龄超过70岁的白种女性的hsTnI水平与心血管不良事件相关性的临床研究。本研究共纳入了1081名老年女性,在研究起始(1998),所有研究对象均没有冠心病和可以诊断为急性冠脉综合征的高hsTnI水平,平均随访时间是14.5年,对其