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Int J Cardiol：非阻塞性冠状动脉心肌梗死患者不良预后的预测因素！

2018-03-14 xing.T MedSci原创

MINOCA不良预后预测因素
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由此可见，预测MINOCA患者新发MACE和死亡的临床因素与之前预测心肌梗死和阻塞性冠状动脉疾病患者心血管事件的因素惊人的相似。

非阻塞性冠状动脉心肌梗死（MINOCAs）是一种越来越受重视的疾病。以前没有研究评估MINOCA患者新发主要不良心脏事件（MACE）和死亡的预测因子。近日，心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章，研究人员对2003年7月至2013年6月期间并随访至2013年12月得到终点事件的MINOCA患者进行了观察性研究。

在199163名MI入院患者中，研究人员确定了9092名MINOCA患者。平均年龄为65.5岁，62%为女性 。MACE定义为全因死亡、急性心肌梗死住院，缺血性卒中和心力衰竭。研究人员采用Cox回归计算了风险比和95%可信区间（HR，95%CI）。

在4.5 年随访期间，共有2147例患者（24%）出现新的MACE，并且1254例（14%）患者发生死亡。调整后的MACE的独立预测因子包括年龄（1.05；1.04–1.06）、糖尿病（1.44；1.21–1.70）、高血压（1.25；1.09–1.43）、吸烟（1.38；1.15–1.66）、心肌梗死（1.38；1.04–2.82）、既往卒中（1.69；1.35–2.11）、外周血管疾病（1.55；1.97–2.23）、慢性阻塞性肺疾病（1.63；1.32–2）、左室射血分数降低（2；1.54–2.60）、总胆固醇水平较低（0.88；0.83–0.94）和肌酐水平较高（1.01；1–1.03）。全因死亡的独立预测因子为年龄、当前吸烟、糖尿病、癌症、慢性阻塞性肺疾病、既往卒中、左心室射血分数减少、总胆固醇水平降低、肌酐和CRP水平升高。

由此可见，预测MINOCA患者新发MACE和死亡的临床因素与之前预测心肌梗死和阻塞性冠状动脉疾病患者心血管事件的因素惊人的相似。

原始出处：

A.M. Nordenskjöld,et al. Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.03.056

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    2019-02-04 仁者大医

    #Cardiol#

    0

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    2018-11-11 tomyang96

    #阻塞#

    0

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    2018-03-31 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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    2018-03-31 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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    2018-03-16 朱睿睿

    #预测因素#

    0

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    2018-03-16 thinkibmz_44722594

    #不良预后#

    0

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    2018-03-15 惠映实验室

    学习了.谢谢分享.

    0

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    2018-03-14 有备才能无患

    非阻塞性冠状动脉心肌梗死(MINOCAs)是一种越来越受重视的疾病.以前没有研究评估MINOCA患者新发主要不良心脏事件(MACE)和死亡的预测因子.近日.心血管领域权威杂志InternationalJournalofCardiology上发表了一篇研究文章.研究人员对2003年7月至2013年6月期间并随访至2013年12月得到终点事件的MINOCA患者进行了观察性研究.

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