Clinical characteristics, risk factors, and prognostic analyses of coronary small vessel disease: a retrospective cohort study of 986 patients.

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL Postgraduate Medicine Pub Date : 2023-08-01 DOI:10.1080/00325481.2023.2221110

Yue Chen, Xiao Cui, Liujun Jiang, Xiaolei Xu, Chaoyang Huang, Qiwen Wang

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Abstract

Background and aims: Coronary small vessel disease (CSVD) is often associated with significant percutaneous coronary intervention (PCI) related complications, complex lesions, complex PCI, and poor long-term prognosis. We designed this retrospective study to clarify the characteristics, risk factors, and prognostic analyses of CSVD in Chinese populations.

Methods: A total of 986 patients who underwent coronary angiography and stent implantation at the First Affiliated Hospital of Zhejiang University School of Medicine were evaluated. Patients were grouped into CSVD or non-small vessel disease (non-CSVD) according to stent diameter. Clinical data, coronary angiography, and long-term follow-up were recorded. Multivariate logistic regression, the Kaplan-Meier method, Log-rank Test, and Cox regression model were used for statistical analysis.

Results: Alcohol consumption (OR = 0.420, 95% CI: 0.299-0.588, P < 0.001) was implicated as a negative CSVD correlation factor. CSVD was more likely to be associated with multi-vessel lesions (79.2% vs. 49.4%, P < 0.001), bifurcation lesions (24.0% vs. 12.4%, P < 0.001), chronic total obstruction lesions (29.5% vs. 9.4%, P < 0.001), and long lesions (55.2% vs. 35.7%, P < 0.001), which reduced the efficacy of revascularization (70.1% vs. 85.1%, P < 0.001). In the follow-ups, cardiac death (2.3% vs. 0.4%, P = 0.008), stroke (1.9% vs. 0.3%, P = 0.007), target lesion revascularization (5.8% vs. 2.9%, P = 0.029), target vessel revascularization (6.8% vs. 3.4%, P = 0.016), and non-target vessel revascularization (7.8% vs. 4.0%, P = 0.012) were all substantially higher in CSVD patients. Troponin I level (OR = 1.008, 95% CI: 1.004-1.012, P < 0.001), complete revascularization (OR = 0.292, 95% CI: 0.160-0.531, P < 0.001), and aspirin administration (OR = 0.041, 95% CI: 0.013-0.131, P < 0.001) were independent predictors of MACE events of all patients.

Conclusion: Compared to non-CSVD, CSVD was associated with more complex lesions, had worse revascularization efficacy, and a poorer prognosis.

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冠状动脉小血管疾病的临床特征、危险因素和预后分析:一项986例患者的回顾性队列研究

背景与目的:冠状动脉小血管疾病(CSVD)常伴有明显的经皮冠状动脉介入治疗(PCI)相关并发症、复杂病变、复杂PCI、长期预后差。我们设计了这项回顾性研究，以阐明中国人群心血管疾病的特征、危险因素和预后分析。方法:对在浙江大学医学院第一附属医院行冠状动脉造影及支架植入术的986例患者进行评价。根据支架直径将患者分为CSVD和非小血管病变(non-CSVD)两组。记录临床资料、冠状动脉造影和长期随访。采用多元逻辑回归、Kaplan-Meier法、Log-rank检验和Cox回归模型进行统计分析。结果:酒精摄入(OR = 0.420, 95% CI: 0.290 -0.588, P P P P P P P P P P = 0.008)、卒中(1.9% vs. 0.3%， P = 0.007)、靶病变血运重建术(5.8% vs. 2.9%， P = 0.029)、靶血管血运重建术(6.8% vs. 3.4%， P = 0.016)和非靶血管血运重建术(7.8% vs. 4.0%， P = 0.012)在CSVD患者中均显著较高。肌钙蛋白I水平(OR = 1.008, 95% CI: 1.004-1.012, P P P P)结论:与非CSVD患者相比，CSVD患者病变更复杂，血运重建效果差，预后较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Postgraduate Medicine 医学-医学：内科

CiteScore

6.10

自引率

2.40%

发文量

110

审稿时长

6-12 weeks

期刊介绍： Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916, Postgraduate Medicine was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.