Ann Intern Med:眼科手术后急性心肌梗塞的风险

2022-03-25 MedSci原创 MedSci原创

在门诊进行的眼科手术似乎与急性心肌梗死风险增加无关。

急性心肌梗塞仍然是全世界发病率和死亡率的主要原因。在门诊眼科手术之前通常进行术前心血管评估。然而,这些眼科手术是否会引发急性心肌梗死尚未明确。近日,内科学权威杂志Annals of Internal Medicine上发表了一篇研究文章,该研究旨在评估与眼科手术相关的急性心肌梗死的短期风险。

研究人员通过案例交叉设计在挪威和瑞典进行了基于人群的全国性研究。参与者为挪威(2008年至2014年)和瑞典(2001年至2014年)的首次急性心肌梗死患者,他们年龄在40岁及以上,通过住院登记来确定,并与门诊手术相链接。

研究人员使用自我匹配的方式,对于每个参与者,将急性心肌梗死诊断前0至7天(危险期)的眼科手术暴露情况与诊断前8天至30天,以及急性心肌梗死前29至36天(对照期)进行比较,以估计眼科手术后一周发生急性心肌梗死的相对风险。研究人员使用条件Logistic回归计算具有95%CI的比值比(OR),仅纳入了在危险期或对照期进行过相关手术的患者。

对于本研究中纳入的806名急性心肌梗死患者,眼科手术后一周内发生急性心肌梗死的可能性低于对照组(OR为0.83;95%CI为0.75至0.91)。此外,当按手术亚型、麻醉(局部或全身)、持续时间、侵入性(低、中或高)、患者年龄(<65岁或≥65岁)或合并症(无与任何)进行分层分析时,没有证据表明急性心肌梗死风险增加。

由此可见,在门诊进行的眼科手术似乎与急性心肌梗死风险增加无关。

原始出处:

Abhijit Sen,et al. Risk for Acute Myocardial Infarction After Ophthalmologic Procedures.Ann Intern Med 2022.https://www.acpjournals.org/doi/10.7326/M20-6618

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